Doctor Name: | DR. PHILLIP WATSON |
NPI Number: | 1568453991 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME 30462 |
Business Practice Address: | 13185 Coronado Dr North Miami, FL - 331812153 |
Business Phone Number: | 3052137980 |
Business Fax Number: | |
Mailing Address: | 13185 Coronado Dr, NORTH MIAMI |
State: | FL |
Postal Code: | 331812153 |
Phone Number: | 3052137980 |
Fax Number: | |
NPI Enumeration Date: | 11/03/2005 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME 30462 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |