Healthcare Provider Details

I. General information

NPI: 1992779474
Provider Name (Legal Business Name): DAVID T WATSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13020 N TELECOM PKWY
TEMPLE TERRACE FL
33637-0925
US

IV. Provider business mailing address

5901 E FOWLER AVE
TEMPLE TERRACE FL
33617-2304
US

V. Phone/Fax

Practice location:
  • Phone: 813-978-9700
  • Fax: 813-558-6147
Mailing address:
  • Phone: 813-978-9700
  • Fax: 813-972-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME94441
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME94441
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberME94441
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: