Provider Demographics
NPI:1780062604
Name:WATSON, RONALD GILBERT JR (APRN/CRNA)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:GILBERT
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:APRN/CRNA
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Mailing Address - Street 1:20274 CENTRAL AVE W
Mailing Address - Street 2:
Mailing Address - City:BLOUNTSTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:32424-1957
Mailing Address - Country:US
Mailing Address - Phone:850-353-7689
Mailing Address - Fax:850-674-8889
Practice Address - Street 1:20274 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:BLOUNTSTOWN
Practice Address - State:FL
Practice Address - Zip Code:32424-1957
Practice Address - Country:US
Practice Address - Phone:850-353-7689
Practice Address - Fax:850-674-8889
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2022-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN9359305207P00000X, 207Q00000X
FLARNP9359305367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered