MEDICARE: DR. GRETA WATTS MD

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
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	ME109307	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871555227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRETA WATTS MD

Provider Business Mailing Address
First Line	:	12470 TELECOM DR STE 300W
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12470 TELECOM DR STE 300
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0904
Country	:	US
Telephone Number	:	813-877-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	02/20/2020

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Directions to “ DR. GRETA WATTS MD” Practice Location

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