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Organization
STEVEN WIGDOR OD PA
Active
Organization
STEVEN WIGDOR OD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN WIGDOR OD (OPTOMETRIST OWNER)
(954) 943-6210
Entity
Organization
Contact information
Practice address
3650 N FEDERAL HWY, LIGHTHOUSE POINT, FL 33064-6649
(954) 943-6210
(954) 943-5148
Mailing address
3650 N FEDERAL HWY, LIGHTHOUSE POINT, FL 33064-6649
(954) 943-6210
(954) 943-5148
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078392700
—
FL
01
—
5821020003
MEDICARE DME
FL
01
—
Q0243A
MEDICARE GROUP NUMBER
FL
Enumeration date
01/29/2007
Last updated
07/14/2014
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