Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PTA 26804 | FL |
NPI | 1003360157 |
---|---|
Provider Name | Carlos Forte |
First Address | Hialeah, FL 33012-3617 |
Second Address | Pembroke Pines, FL 33024-6175 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2016 |
Last Update Date | 06/08/2016 |