Provider Demographics
NPI:1154293165
Name:KORI WATKINS, OD
Entity type:Organization
Organization Name:KORI WATKINS, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:321-503-4624
Mailing Address - Street 1:792 S US 1
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-4701
Mailing Address - Country:US
Mailing Address - Phone:772-770-2020
Mailing Address - Fax:772-770-4617
Practice Address - Street 1:792 S US 1
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32962-4701
Practice Address - Country:US
Practice Address - Phone:772-770-2020
Practice Address - Fax:772-770-4617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty