Provider Demographics
NPI:1831238864
Name:WATCH, LIBBY SUSAN (MD)
Entity type:Individual
Prefix:DR
First Name:LIBBY
Middle Name:SUSAN
Last Name:WATCH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8950 N KENDALL DR
Mailing Address - Street 2:504
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2144
Mailing Address - Country:US
Mailing Address - Phone:305-274-2030
Mailing Address - Fax:305-279-0878
Practice Address - Street 1:8950 N KENDALL DR
Practice Address - Street 2:504
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2144
Practice Address - Country:US
Practice Address - Phone:305-274-2030
Practice Address - Fax:305-279-0878
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2017-03-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME109569208600000X
FL1095692086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004273400Medicaid
FLFQ477ZMedicare PIN