Organization
WATSON CLINIC LLP
Active
Other names
Watson Clinic LLP Center for Rehabilitative Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON HIRSBRUNNER (CHIEF EXECUTIVE OFFICER)
(863) 680-7007
Entity
Organization
Contact information
Practice address
1430 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3202
(863) 680-7700
Mailing address
1430 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3202
(863) 680-7700
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
880988700
—
FL
01
—
G25
BCBS
FL
Enumeration date
12/07/2007
Last updated
03/01/2024
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