| Entity Name: | WHEELER WIGGINS, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 29 Jul 2010 (14 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P10000062381 |
| Address: | 1175 N.E. 125TH STREET, 205, MIAMI, FL 33161 |
| Mail Address: | 1175 N.E. 125TH STREET, 205, MIAMI, FL 33161 |
| ZIP code: | 33161 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669789319 | 2010-09-01 | 2010-09-01 | 1175 NE 125TH ST, SUITE 205, NORTH MIAMI, FL, 331615015, US | 4330 W BROWARD BLVD, SUITE R, PLANTATION, FL, 333173775, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-825-5698 |
| Fax | 3058951737 |
Authorized person
| Name | MR. CARTER TYRONE WIGGINS |
| Role | PARTNER |
| Phone | 3058255698 |
Taxonomy
| Taxonomy Code | 101YA0400X - Addiction (Substance Use Disorder) Counselor |
| License Number | 80292 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 1041C0700X - Clinical Social Worker |
| License Number | SW4348 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000109300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| WIGGINS, CARTER T | Agent | 1175 N.E. 125TH STREET, 205, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| WIGGINS, CARTER T | President | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| WHEELER, GUY | President | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| WIGGINS, CARTER T | Director | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| WHEELER, GUY | Director | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| EASON, VELMA | Director | 1175 NE 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| GILFORD, VERA | Director | 1175 NE 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| WIGGINS, CARTER T | Treasurer | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| WHEELER, GUY | Vice President | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| WHEELER, GUY | Secretary | 1175 N.E. 125TH STREET, SUITE 205, MIAMI, FL 33161 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| Domestic Profit | 2010-07-29 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
