Individual
AUDREY WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2126 VALRICO HEIGHTS BLVD, VALRICO, FL 33594-6778
(813) 689-4243
Mailing address
2126 VALRICO HEIGHTS BLVD, VALRICO, FL 33594-6778
(866) 367-4316
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
11/10/2010
Last updated
08/01/2015
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