Organization
WIGLEY FOOT AND ANKLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WIGLEY IV DPM (OWNER)
(305) 895-9528
Entity
Organization
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
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010794200
—
FL
Enumeration date
03/27/2014
Last updated
06/13/2019
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