Provider Demographics
NPI:1528054509
Name:WATKINS, ANTOININA (MD)
Entity type:Individual
Prefix:DR
First Name:ANTOININA
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 W SANTIAGO ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-7812
Mailing Address - Country:US
Mailing Address - Phone:813-277-4073
Mailing Address - Fax:
Practice Address - Street 1:2919 W SWANN AVE STE 303
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4051
Practice Address - Country:US
Practice Address - Phone:813-569-0740
Practice Address - Fax:813-864-7603
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89921207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271373000Medicaid
FL52367ZMedicare ID - Type Unspecified
FL271373000Medicaid