Provider Demographics
NPI:1447994983
Name:WATKINS, KORI (OD)
Entity type:Individual
Prefix:DR
First Name:KORI
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:
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:727-770-2020
Practice Address - Fax:772-770-4617
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-21
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT128558109934152W00000X, 152WC0802X
FLOPC6380152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management