Individual ProviderDeanna J WathingtonFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address12901 Bruce B Downs Blvd, Tampa, FL 33612-4742(813) 974-2201PECOS EnrollmentBased on the most recent information from CMS, provider Deanna J Wathington does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1164451365Provider TypeIndividualFull NameWathington, Deanna JCredentialMDGenderMaleSole ProprietorNoEnumeration Date7/1/2006Last Updated3/19/2008Contact InformationPractice LocationPractice Address12901 Bruce B Downs Blvd, Tampa, FL 33612-4742Phone(813) 974-2201FaxUnlisted FaxMailing LocationMailing AddressPO Box 917770, Orlando, FL 32891-7770PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseME74267FloridaProvider IdentifiersIDDescriptionIssuerID42893DescriptionOtherIssuerBLUE CROSS BLUE SHIELDFlorida