Active NPI
Mariposa Wellness LLC
- Neurorehabilitation Occupational Therapist
- Wimauma, FL
National Provider Identifier
1619854411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurorehabilitation Occupational Therapist
- Legal business name
- MARIPOSA WELLNESS LLC
- Practice address
- 16712 Magnolia Reserve PL
Wimauma, FL 33598-4074 - Phone
- (813) 503-0169
- NPI assigned
- Aug 21, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stefanie Perez Watson, OT
- Title
- Occupational Therapist
- Phone
- (813) 503-0169
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurorehabilitation Occupational Therapist | 225XN1300X | Primary | ||
| Physical Therapy Clinic/Center | 261QP2000X |
Addresses
Primary practice location
16712 Magnolia Reserve PL
Wimauma, FL 33598-4074
Mailing address
16712 Magnolia Reserve PL
Wimauma, FL 33598-4074
Phone (910) 420-3397
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755734400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758153600000",
"number": "1619854411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16712 MAGNOLIA RESERVE PL",
"city": "WIMAUMA",
"state": "FL",
"postal_code": "335984074",
"telephone_number": "910-420-3397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16712 MAGNOLIA RESERVE PL",
"city": "WIMAUMA",
"state": "FL",
"postal_code": "335984074",
"telephone_number": "813-503-0169"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARIPOSA WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-08-21",
"last_updated": "2025-09-18",
"certification_date": "2025-09-18",
"status": "A",
"authorized_official_last_name": "WATSON",
"authorized_official_first_name": "STEFANIE",
"authorized_official_middle_name": "PEREZ",
"authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
"authorized_official_telephone_number": "813-503-0169",
"authorized_official_credential": "OT"
},
"taxonomies": [
{
"code": "225XN1300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist, Neurorehabilitation",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wimauma, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.