Healthcare Provider Details

I. General information

NPI: 1417535188
Provider Name (Legal Business Name): REBEKAH WATSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 OVERSEAS HWY STE 38
MARATHON FL
33050-2744
US

IV. Provider business mailing address

5800 OVERSEAS HWY STE 38
MARATHON FL
33050-2744
US

V. Phone/Fax

Practice location:
  • Phone: 305-743-7111
  • Fax: 305-743-7709
Mailing address:
  • Phone: 305-743-7111
  • Fax: 305-743-7709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11010969
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: