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General NPI Number Information
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NPI Number | 1336698315
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Entity Type | Organization
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Legal Business Name | DR. STEVEN E. WIGDOR, P.A.
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Dates
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Enumeration Date | 10/01/2016
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 17941 BISCAYNE BLVD
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City | AVENTURA
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State | FL
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Zip | 33160-2502
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Country | US
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Telephone | 305-931-0225
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Fax | 305-931-0238
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Provider Business Mailing Address
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Address Line | 17941 BISCAYNE BLVD
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City | AVENTURA
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State | FL
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Zip | 33160-2502
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Country | US
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Telephone | 305-931-0225
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Fax | 305-931-0238
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. STEVEN E WIGDOR
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Credential | OD
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Telephone | 305-931-0225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC1791
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License Number State | FL
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