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General NPI Number Information
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NPI Number | 1437131604
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Entity Type | Individual
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Provider Name | STANLEY L WIGGINS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 1261 VISCAYA PKWY STE 101
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City | CAPE CORAL
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State | FL
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Zip | 33990-3252
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Country | US
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Telephone | 239-573-7337
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Fax | 239-574-5883
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Provider Business Mailing Address
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Address Line | 12730 NEW BRITTANY BLVD STE 602
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City | FORT MYERS
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State | FL
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Zip | 33907-4690
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Country | US
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Telephone | 239-275-5522
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Fax | 239-275-4464
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME91060
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License Number State | FL
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