Provider Demographics
NPI:1235112400
Name:WATT, BRITANEY MAE (BS, DC)
Entity Type:Individual
Prefix:MRS
First Name:BRITANEY
Middle Name:MAE
Last Name:WATT
Suffix:
Gender:F
Credentials:BS, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 N. WICKHAM ROAD #109
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935
Mailing Address - Country:US
Mailing Address - Phone:321-253-8511
Mailing Address - Fax:321-253-8711
Practice Address - Street 1:2255 N. WICKHAM ROAD #109
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-253-8511
Practice Address - Fax:321-253-8711
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7835111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381266900Medicaid
FL55966YMedicare ID - Type Unspecified
U79823Medicare UPIN