Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | PO3944 | FL |
NPI | 1063874584 |
---|---|
Provider Name | Dr. Joseph Thomas Watson |
First Address | Miami Lakes, FL 33014-7014 |
Second Address | Daytona Beach, FL 32117-7131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 27/06/2019 |