Provider Demographics
NPI:1568690220
Name:FORBES, ANIKA C (DO)
Entity Type:Individual
Prefix:
First Name:ANIKA
Middle Name:C
Last Name:FORBES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7855 ARGYLE FOREST BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-5597
Mailing Address - Country:US
Mailing Address - Phone:904-282-6331
Mailing Address - Fax:904-619-1080
Practice Address - Street 1:1560 KINGSLEY AVE STE 2
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-9200
Practice Address - Country:US
Practice Address - Phone:904-661-2301
Practice Address - Fax:904-661-2300
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT0132952084P0800X
FLOS126922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013048300Medicaid