Healthcare Provider Details

I. General information

NPI: 1538302021
Provider Name (Legal Business Name): PETRA KAYE MCEWAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PETRA KAYE WATSON MD

II. Dates (important events)

Enumeration Date: 04/13/2009
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 COCOANUT ROW STE 100
PALM BEACH FL
33480-4027
US

IV. Provider business mailing address

50 COCOANUT ROW STE 100
PALM BEACH FL
33480-4027
US

V. Phone/Fax

Practice location:
  • Phone: 561-200-7000
  • Fax:
Mailing address:
  • Phone: 561-200-7000
  • Fax: 561-366-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME112066
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: