| Wheeler Wiggins, P.a. | |
|
4330 W Broward Blvd Suite R Plantation FL 33317-3775 | |
| (305) 825-5698 | |
| (305) 895-1737 |
| Full Name | Wheeler Wiggins, P.a. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4330 W Broward Blvd, Plantation, Florida |
| Authorized Official Name and Position | Carter Tyrone Wiggins (PARTNER) |
| Authorized Official Contact | 3058255698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wheeler Wiggins, P.a. 1175 Ne 125th St Suite 205 North Miami FL 33161-5015 Ph: (305) 825-5698 | Wheeler Wiggins, P.a. 4330 W Broward Blvd Suite R Plantation FL 33317-3775 Ph: (305) 825-5698 |
| NPI Number | 1669789319 |
|---|---|
| Provider Enumeration Date | 09/01/2010 |
| Last Update Date | 09/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669789319 | NPI | - | NPPES |
| 000109300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 80292 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | SW4348 (Florida) | Primary |
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