Provider Demographics
NPI:1306201025
Name:FORREST, ANNE (OT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:FORREST
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 SW 60TH AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6469
Mailing Address - Country:US
Mailing Address - Phone:352-433-1918
Mailing Address - Fax:352-433-0950
Practice Address - Street 1:3002 SE 1ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471
Practice Address - Country:US
Practice Address - Phone:352-216-6836
Practice Address - Fax:352-248-0924
Is Sole Proprietor?:No
Enumeration Date:2015-12-22
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT4461225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIS798ZMedicare PIN