Individual
DR. BRETT WAYNE FORREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4200 CONROY RD, SPACE L-201, ORLANDO, FL 32839-2400
(407) 903-1018
(407) 903-1063
Mailing address
4200 CONROY RD, SPACE L-201, ORLANDO, FL 32839-2400
(407) 903-1018
(407) 903-1063
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC2587
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC2587
FL
152WX0102X
Occupational Vision Optometrist
OPC2587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078940200
—
FL
01
—
1356
ARIZONA LICENSE
AZ
01
—
OPC2587
LICENSE NUMBER
FL
Enumeration date
05/15/2007
Last updated
05/03/2016
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