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Organization
WATSON CLINIC LLP
Active
Organization
WATSON CLINIC LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HIRSBRUNNER (CHIEF EXECUTIVE OFFICER)
(863) 680-7007
Entity
Organization
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3019
(863) 680-7000
(866) 264-8519
Mailing address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3019
(863) 680-7000
(866) 264-8519
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053990200
—
FL
01
—
200568900
PC-ACE PROGRAM
FL
Enumeration date
05/31/2005
Last updated
03/01/2024
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