MEDICARE: DR. RUDY FORTE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	ME155908	FL
2	207R00000X	Internal Medicine Physician	ME155908	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962066613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUDY FORTE MD

Provider Business Mailing Address
First Line	:	9330 STATE ROAD 54
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-1808
Country	:	US
Telephone Number	:	727-834-4868
Fax Number	:

Provider Business Practice Location Address
First Line	:	9330 STATE ROAD 54
Second Line	:
City	:	TRINITY
State	:	FL
Zip	:	34655-1808
Country	:	US
Telephone Number	:	727-834-4868
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/29/2019
Last Update Date	:	12/11/2025

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Directions to “ DR. RUDY FORTE MD” Practice Location

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