Healthcare Provider Details

I. General information

NPI: 1831335603
Provider Name (Legal Business Name): ANTHONY WATKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 10/09/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 BAYSHORE BLVD
TAMPA FL
33606-2707
US

IV. Provider business mailing address

PO BOX 1289
TAMPA FL
33601-1289
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-5544
  • Fax:
Mailing address:
  • Phone: 813-844-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number252958
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number252958
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: