Provider Demographics
NPI:1437581196
Name:FOREHAND, RAYMOND LEE (OD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LEE
Last Name:FOREHAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 BEACH RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-3133
Mailing Address - Country:US
Mailing Address - Phone:904-556-1610
Mailing Address - Fax:
Practice Address - Street 1:13205 REAMS RD UNIT 152
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-9543
Practice Address - Country:US
Practice Address - Phone:407-895-6254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC005430152W00000X
IL046.010724152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist