Individual
DR. KIRSTEN REED WILGERS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5820 WILLIAMSON BLVD, SUITE 106, PORT ORANGE, FL 32128-6100
(386) 767-4449
(386) 767-1980
Mailing address
5820 S WILLIAMSON BLVD, STE 106, PORT ORANGE, FL 32128-6400
(386) 767-4449
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC3622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010470
FLORIDA HEALTH CARE
FL
01
—
5021890001
DMERC
FL
01
—
542098594
VISIONCARE PLANS
FL
05
—
620669700
—
FL
05
—
620815100
—
FL
01
—
FL3622
EYEMED
FL
Enumeration date
08/17/2005
Last updated
03/29/2017
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