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NPI Code Detail

MEDICARE: WATSON CLINIC LLP

MEDICARE: WATSON CLINIC LLP
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
1207RC0000XCardiovascular Disease Physician
2207RE0101XEndocrinology, Diabetes & Metabolism Physician
3207RI0011XInterventional Cardiology Physician
4207RG0100XGastroenterology Physician
5207RI0200XInfectious Disease Physician
6207K00000XAllergy & Immunology Physician
7207Q00000XFamily Medicine Physician
8207RN0300XNephrology Physician
9207RP1001XPulmonary Disease Physician
10207RR0500XRheumatology Physician
11207V00000XObstetrics & Gynecology Physician
12207W00000XOphthalmology Physician
13207X00000XOrthopaedic Surgery Physician
14261QM1300XMulti-Specialty Clinic/Center
15207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1200568900OTHERFLPC-ACE PROGRAM
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316940695
Entity Type Code : Organization
Provider Name (Legal Business Name) : WATSON CLINIC LLP
Provider Business Mailing Address
First Line : 1600 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3019
Country : US
Telephone Number : 863-680-7000
Fax Number : 866-264-8519
Provider Business Practice Location Address
First Line : 1600 LAKELAND HILLS BLVD
Second Line :
City : LAKELAND
State : FL
Zip : 33805-3019
Country : US
Telephone Number : 863-680-7000
Fax Number : 866-264-8519
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : JASON HIRSBRUNNER
Credential :
Telephone Number : 863-680-7007
Provider Enumeration Date : 05/31/2005
Last Update Date : 03/01/2024

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Directions to “WATSON CLINIC LLP ” Practice Location

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