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Individual

DR. STEPHEN WIGLEY IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1595 NE 163RD ST, NORTH MIAMI BEACH, FL 33162-4717
(305) 895-9528
(786) 332-3242
Mailing address
1595 NE 163RD ST, NORTH MIAMI BEACH, FL 33162-4717
(305) 895-9528
(786) 332-3242

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
PO3625
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO3625
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010794200
FL
Enumeration date
03/31/2011
Last updated
06/13/2019
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