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General NPI Number Information
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NPI Number | 1366421059
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Entity Type | Individual
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Provider Name | TATIANA WELLENS PICOT DPM, PHD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 101 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4630
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Country | US
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Telephone | 863-299-4551
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Fax | 863-299-2310
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Provider Business Mailing Address
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Address Line | 101 6TH ST NW
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4630
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Country | US
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Telephone | 863-299-4551
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Fax | 863-299-2310
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO2760
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License Number State | FL
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