Healthcare Provider Details

I. General information

NPI: 1821213299
Provider Name (Legal Business Name): SHEILA DENISE SIMMS WATSON L.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17304 WALKER AVE
MIAMI FL
33157-4389
US

IV. Provider business mailing address

9745 SW 161ST ST
MIAMI FL
33157-3315
US

V. Phone/Fax

Practice location:
  • Phone: 786-287-0484
  • Fax: 305-235-6688
Mailing address:
  • Phone: 786-287-0484
  • Fax: 305-235-6688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberMW 141
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: