Provider Demographics
NPI:1144323023
Name:FORSTOT, JOSEPH Z (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:Z
Last Name:FORSTOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NW 15TH ST
Mailing Address - Street 2:SUITE 208A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1375
Mailing Address - Country:US
Mailing Address - Phone:561-368-5611
Mailing Address - Fax:561-395-2835
Practice Address - Street 1:1050 NW 15TH ST
Practice Address - Street 2:SUITE 212A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1375
Practice Address - Country:US
Practice Address - Phone:561-368-5611
Practice Address - Fax:561-395-2835
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 28962207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD55923Medicare UPIN
FL50964ZMedicare ID - Type Unspecified