Healthcare Provider Details

I. General information

NPI: 1871442871
Provider Name (Legal Business Name): MELISSA WATKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13399 BANNER RD
SPRING HILL FL
34609-6007
US

IV. Provider business mailing address

13399 BANNER RD
SPRING HILL FL
34609-6007
US

V. Phone/Fax

Practice location:
  • Phone: 352-442-0590
  • Fax:
Mailing address:
  • Phone: 352-442-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW17220
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: