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General NPI Number Information
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NPI Number | 1023946290
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Entity Type | Individual
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Provider Name | WINSTON PEREZ
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Gender | Male
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Dates
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Enumeration Date | 05/09/2026
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Last Update Date | 05/09/2026
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Provider Practice Location Address
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Address Line | 600 MOUNT PLEASANT AVE # 9
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City | PROVIDENCE
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State | RI
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Zip | 02908-1940
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Country | US
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Telephone | 401-456-8042
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Fax |
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Provider Business Mailing Address
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Address Line | 80 GARFIELD AVE APT E
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City | CRANSTON
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State | RI
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Zip | 02920-7819
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Country | US
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Telephone | 508-410-3732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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