Healthcare Provider Details

I. General information

NPI: 1134734072
Provider Name (Legal Business Name): MEGAN ANNE WATKINS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 10/04/2020
Certification Date: 10/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CATTLEMAN RD SUITE 600
SARASOTA FL
34232
US

IV. Provider business mailing address

5867 PAUMA CT
SARASOTA FL
34232-5939
US

V. Phone/Fax

Practice location:
  • Phone: 941-955-5191
  • Fax:
Mailing address:
  • Phone: 239-410-3777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAPRN11007395
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: