Provider Demographics
NPI:1518607027
Name:FORBES, RIANN MICHELLE
Entity Type:Individual
Prefix:
First Name:RIANN
Middle Name:MICHELLE
Last Name:FORBES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11883 SW 9TH MNR
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3892
Mailing Address - Country:US
Mailing Address - Phone:954-815-3012
Mailing Address - Fax:
Practice Address - Street 1:15600 NW 15TH AVE STE C
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-5609
Practice Address - Country:US
Practice Address - Phone:305-548-2926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL63641183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist