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General NPI Number Information
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NPI Number | 1689644437
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Entity Type | Organization
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Legal Business Name | CARTER T WIGGINS & ASSOCIATES PA
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 05/19/2020
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Provider Practice Location Address
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Address Line | 12955 BISCAYNE BLVD STE 204
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2021
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Country | US
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Telephone | 305-895-3307
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Fax | 305-895-1737
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Provider Business Mailing Address
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Address Line | 12955 BISCAYNE BLVD STE 204
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City | NORTH MIAMI
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State | FL
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Zip | 33181-2021
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Country | US
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Telephone | 305-895-3307
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Fax | 305-895-1737
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARTER T WIGGINS
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Credential | LCSW
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Telephone | 305-825-5698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW4348
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License Number State | FL
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