Look up the most recent NPI and PECOS records

Deanna J Wathington

Family Medicine

Allopathic & Osteopathic Physicians

12901 Bruce B Downs Blvd, Tampa, FL 33612-4742

PECOS Enrollment

Based on the most recent information from CMS, provider Deanna J Wathington does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 40 days ago.

Profile Details

Provider ID
1164451365
Provider Type
Individual
Full Name
Wathington, Deanna J
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
7/1/2006
Last Updated
3/19/2008

Contact Information

Practice Location

12901 Bruce B Downs Blvd, Tampa, FL 33612-4742

(813) 974-2201

Unlisted Fax

Mailing Location

PO Box 917770, Orlando, FL 32891-7770

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License ME74267 Florida

Provider Identifiers

ID	Description	Issuer
ID 42893	Description Other	Issuer BLUE CROSS BLUE SHIELD Florida

Deanna J Wathington

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Glenn, Dana

Nguyen, Anhvu Tien

Bhamidipati, Savithri

Stennett, Naima

Olson, Christopher E

Perkins, Randa M

Walicki, Celeste L.

Saric, Gregory F

Gonzalez, Eduardo

Uhlar, Courtney L