Provider Demographics
NPI:1891152310
Name:TROXLER WATSON, ANTOINETTE (AGACNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:TROXLER WATSON
Suffix:
Gender:F
Credentials:AGACNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 STANDING STONE DR
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-6172
Mailing Address - Country:US
Mailing Address - Phone:813-924-8406
Mailing Address - Fax:
Practice Address - Street 1:501 N REO ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1012
Practice Address - Country:US
Practice Address - Phone:813-714-7397
Practice Address - Fax:813-462-2921
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9423083363L00000X
FLAPRN9423083363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner