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Organization
STEVEN WIGDOR O.D. P.A.
Active
Organization
STEVEN WIGDOR O.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN WIGDOR O.D. (OWNER)
(305) 931-0225
Entity
Organization
Contact information
Practice address
17941 BISCAYNE BLVD, AVENTURA, FL 33160-2502
(305) 931-0225
(305) 931-0238
Mailing address
17941 BISCAYNE BLVD, AVENTURA, FL 33160-2502
(305) 931-0225
(305) 931-0238
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1791
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
078392701
—
FL
01
—
582102001
MEDICARE DME
FL
01
—
Q0243
MEDICARE GROUP PTAN
FL
Enumeration date
07/22/2006
Last updated
07/14/2014
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