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General NPI Number Information
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NPI Number | 1679479372
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Entity Type | Individual
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Provider Name | STEFANIE PEREZ WATSON OT, CSRS, AIB-VRC
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Gender |
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Dates
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Enumeration Date | 10/19/2026
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Last Update Date | 10/19/2026
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Provider Practice Location Address
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Address Line | 16712 MAGNOLIA RESERVE PL
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City | WIMAUMA
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State | FL
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Zip | 33598-4074
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Country | US
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Telephone | 813-733-5086
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Fax |
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Provider Business Mailing Address
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Address Line | 16712 MAGNOLIA RESERVE PL
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City | WIMAUMA
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State | FL
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Zip | 33598-4074
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Country | US
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Telephone |
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | OT17477
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License Number State | FL
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