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Individual
DR. STEVEN WIGDOR
Active
Individual
DR. STEVEN WIGDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC001791
FL
152WC0802X
Corneal and Contact Management Optometrist
OPC001791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078392700
—
FL
01
—
5821020001
MEDICARE DME SUPPLIER
FL
01
—
5821020002
MEDICARE DME SUPPLIER
FL
Enumeration date
08/18/2005
Last updated
07/01/2010
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