Provider Demographics
NPI:1275010522
Name:FORREST ENTERPRISES LLC
Entity Type:Organization
Organization Name:FORREST ENTERPRISES LLC
Other - Org Name:OLDSMAR CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-855-5986
Mailing Address - Street 1:3906 TAMPA RD STE A
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3100
Mailing Address - Country:US
Mailing Address - Phone:813-855-5988
Mailing Address - Fax:813-855-6378
Practice Address - Street 1:3906 TAMPA RD STE A
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3100
Practice Address - Country:US
Practice Address - Phone:813-855-5988
Practice Address - Fax:813-855-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH4140111N00000X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty