Provider Demographics
NPI:1811277577
Name:DUCATEL, WATSON (DO , MPH)
Entity type:Individual
Prefix:DR
First Name:WATSON
Middle Name:
Last Name:DUCATEL
Suffix:
Gender:M
Credentials:DO , MPH
Other - Prefix:DR
Other - First Name:WATSON
Other - Middle Name:
Other - Last Name:DUCATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO, MPH
Mailing Address - Street 1:3415 BROOK CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-8181
Mailing Address - Country:US
Mailing Address - Phone:813-540-5005
Mailing Address - Fax:
Practice Address - Street 1:3415 BROOK CROSSING DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-8181
Practice Address - Country:US
Practice Address - Phone:813-540-5005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-25
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLUO2785207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine