MEDICARE: DR. EDWARD RAY WATSON 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	207VG0400X	Gynecology Physician	ME35674	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME35674	OTHER	FL	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952522864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD RAY WATSON MD

Provider Business Mailing Address
First Line	:	6660 SW 117TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-2826
Country	:	US
Telephone Number	:	305-630-3363
Fax Number	:	305-630-3364

Provider Business Practice Location Address
First Line	:	6660 SW 117TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-2826
Country	:	US
Telephone Number	:	305-630-3363
Fax Number	:	305-630-3364

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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