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NPI Code Detail

MEDICARE: CHRISTIE CASTILLO WATSON OTR/L

MEDICARE: CHRISTIE CASTILLO WATSON OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist23197FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123197OTHERFLSTATE OF FLORIDA DEPT OF HEALTH
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124259528
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIE CASTILLO WATSON OTR/L
Provider Business Mailing Address
First Line : 3290 BURROWING OWL DR
Second Line :
City : MIMS
State : FL
Zip : 32754-3033
Country : US
Telephone Number : 732-470-4187
Fax Number :
Provider Business Practice Location Address
First Line : 5650 S WASHINGTON AVE
Second Line :
City : TITUSVILLE
State : FL
Zip : 32780-7312
Country : US
Telephone Number : 321-264-0855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2009
Last Update Date : 11/01/2022

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