MEDICARE: COLIN LOREN WATTS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	W 320 122 546 711	MI
2	207R00000X	Internal Medicine Physician	ME114441	FL

General Provider Information

NPI Number	:	1922252097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLIN LOREN WATTS M.D.

Provider Business Mailing Address
First Line	:	701 S ORANGE BLOSSOM TRL
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-6557
Country	:	US
Telephone Number	:	407-703-9990
Fax Number	:	407-703-9991

Provider Business Practice Location Address
First Line	:	701 S ORANGE BLOSSOM TRL
Second Line	:
City	:	APOPKA
State	:	FL
Zip	:	32703-6557
Country	:	US
Telephone Number	:	407-703-9990
Fax Number	:	407-703-9991

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2008
Last Update Date	:	04/26/2024

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