Individual
MRS. AMY MIRIAM FORLEITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
670 GLADES RD STE 220, BOCA RATON, FL 33431-6464
(561) 394-6656
(561) 394-4022
Mailing address
2955 NW 126TH AVE UNIT 223-5, SUNRISE, FL 33323-6334
(781) 254-7377
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
014892
NY
363AS0400X
Surgical Physician Assistant
Primary
PA9109681
FL
Other
Enumeration date
09/30/2010
Last updated
08/27/2019
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