Provider Demographics
NPI:1346608767
Name:LAURENCE WATKINS MD
Entity type:Organization
Organization Name:LAURENCE WATKINS MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:O
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:772-232-6009
Mailing Address - Street 1:533 NW PINESAP PL
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-3522
Mailing Address - Country:US
Mailing Address - Phone:772-232-6009
Mailing Address - Fax:772-232-6054
Practice Address - Street 1:533 NW PINESAP PL
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-3522
Practice Address - Country:US
Practice Address - Phone:772-232-6009
Practice Address - Fax:772-232-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty