Provider Demographics
NPI:1558604116
Name:WATSON, ADRIENNE MEE-LING (ARNP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MEE-LING
Last Name:WATSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13110 ELK MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-7182
Mailing Address - Country:US
Mailing Address - Phone:813-349-7569
Mailing Address - Fax:813-349-7561
Practice Address - Street 1:14254 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:FL
Practice Address - Zip Code:33527-4414
Practice Address - Country:US
Practice Address - Phone:813-349-7700
Practice Address - Fax:813-938-6422
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN 9182123364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health