| J. Michael Forrest Md Pa | |
|
7420 Nw 5th St Suite 105 Plantation FL 33317-1611 | |
| (954) 583-6311 | |
| (954) 583-6492 |
| Full Name | J. Michael Forrest Md Pa |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 7420 Nw 5th St, Plantation, Florida |
| Authorized Official Name and Position | John Michael Forrest (PHYSICIAN) |
| Authorized Official Contact | 9545836311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Michael Forrest Md Pa 7420 Nw 5th St Suite 105 Plantation FL 33317-1611 Ph: (954) 583-6311 | J. Michael Forrest Md Pa 7420 Nw 5th St Suite 105 Plantation FL 33317-1611 Ph: (954) 583-6311 |
| NPI Number | 1063687507 |
|---|---|
| Provider Enumeration Date | 04/25/2008 |
| Last Update Date | 04/25/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063687507 | NPI | - | NPPES |
| 375981400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME0062996 (Florida) | Primary |
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