Individual
DANIEL M FORREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-3585
(321) 799-7111
(770) 237-4866
Mailing address
PO BOX 2400, MELBOURNE, FL 32902-2400
(866) 744-1461
(770) 621-3181
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
OS9529
FL
2085N0904X
Nuclear Radiology Physician
OS9529
FL
2085P0229X
Pediatric Radiology Physician
OS9529
FL
2085R0202X
Diagnostic Radiology Physician
Primary
OS9529
FL
2085R0204X
Vascular & Interventional Radiology Physician
OS9529
FL
2085U0001X
Diagnostic Ultrasound Physician
OS9529
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16487
BCBS
FL
01
—
16487W
MEDICARE PTAN
FL
05
—
273327700
—
FL
Enumeration date
08/04/2006
Last updated
08/19/2013
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