Healthcare Provider Details

I. General information

NPI: 1518363951
Provider Name (Legal Business Name): FAMILY FIRST PHYSICIAN SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2014
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 NW FEDERAL HWY
JENSEN BEACH FL
34957-3676
US

IV. Provider business mailing address

4273 NE WATT DR
JENSEN BEACH FL
34957-0016
US

V. Phone/Fax

Practice location:
  • Phone: 772-208-3057
  • Fax: 772-209-4200
Mailing address:
  • Phone: 772-301-9369
  • Fax: 772-209-4200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME109645
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JASON WATT
Title or Position: OWNER
Credential: M.D.
Phone: 561-352-9174