PEDIATRIC SPECIALTY GROUP, INC. (NPI# 1194277756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194277756 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALTY GROUP, INC. |
| Other Organization Name | PEDIATRIC SPECIALISTS OF AMERICA- PSYCHOLOGY |
| Practice Address |
3100 Sw 62nd Ave Department of Psychology Miami FL 33155-3009 |
| Mailing Address |
Po Box 865095 Orlando FL 32886-5095 |
| Practice Telephone | 7866245876 |
| Practice Fax Number | 7866242688 |
| Mailing Telephone | 7866245876 |
| Mailing Fax Number | 7866242688 |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2016-10-31 |
| Authorized Official Name | REBECCA FRANCE (ADMINISTRATIVE DIRECTOR OF RCM) |
| Authorized Official Telephone | 7866245715 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Pediatric Specialists Of America- Psychology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589914 | Pediatric Specialty Group, Inc. | Pediatrics | 9750 Nw 33rd St Ste 109, Coral Springs, FL 33065-4000 | 2019-10-15 |
| 1457965345 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-09-08 |
| 1306459177 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1235774852 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, 1st Floor, Trauma Unit, Miami, FL 33155-3009 | 2019-11-07 |
| 1124553656 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Apcp- 6 Tower, Suite 6226, Miami, FL 33155-3009 | 2017-04-21 |
| 1881128171 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Palliative Care Medicine- 3rd Floor- Suite 6-74, Miami, FL 33155 | 2017-04-13 |
| 1528512001 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Department of Gastroenterology, Miami, FL 33155 | 2016-08-12 |
| 1891249371 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave Ste 102, Miami, FL 33155 | 2016-08-12 |
| 1982158820 | Pediatric Specialty Group, Inc. | Ophthalmology | 3100 Sw 62nd Ave, Miami, FL 33155 | 2016-08-09 |
| 1689128530 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Attention: Physician Rcm @ Blue Lagoon- 8th Floor, Miami, FL 33155-3009 | 2016-08-09 |
| Street Address |
3100 SW 62ND AVE DEPARTMENT OF PSYCHOLOGY |
| City | MIAMI |
| State | FL |
| Zip Code | 33155-3009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824077 | Rene Luis Lopez-guerrero | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2005-07-13 |
| 1598366239 | Alejandra Margarita Patterson | Registered Nurse | 3100 Sw 62nd Ave, Suite 108 Center for Spinal Disorders, Miami, FL 33155 | 2020-11-07 |
| 1093315947 | Mailys Santoro | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-29 |
| 1174121289 | Lilia M Mendoza | Family Medicine | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-12 |
| 1932707007 | Brian Ruiz | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-12 |
| 1457965345 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-09-08 |
| 1306459177 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1568075372 | Nancy Pierre | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1841803335 | Dicle Yasar Aksoyler | Student in an Organized Health Care Education/Training Program | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-25 |
| 1154932952 | Veronica A Quintanar Sanabria | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987121 | Blanca Argentina Torres | Speech-Language Pathologist | 6840 Bird Rd Unit 211a, Miami, FL 33155 | 2020-09-21 |
| 1245888585 | Mila De La Caridad Broche Coego | Behavior Technician | 2247 Sw 68th Ct, Miami, FL 33155 | 2019-08-29 |
| 1265087878 | Nancy Acela Denis | Nurse Practitioner | 6791 Sw 25 Terra, Miami, FL 33155 | 2019-08-09 |
| 1700366887 | Aly Hashim | Family Medicine | 2805 Sw 75th Avenue, Miami, FL 33155 | 2018-08-17 |
| 1184115362 | Ready 2 Transfer, Inc. | Non-emergency Medical Transport (VAN) | 7811 Sw 24 Street #120, Miami, FL 33155 | 2018-05-23 |
| 1053808030 | Idalmis Pimentel Diez | Behavior Technician | 6334 Sw 30th St, Miami, FL 33155 | 2018-04-16 |
| 1225538689 | L & L Social Services LLC | Case Management | 5950 Sw 40 St, Miami, FL 33155 | 2018-02-12 |
| 1659888915 | Red Bird Dental Care | Dentist | 5771 Sw 40 St, Miami, FL 33155 | 2018-01-08 |
| 1043726474 | Jesenia Rodriguez-vila | Nurse Practitioner | 6433 Sw 29th St, Miami, FL 33155 | 2017-12-21 |
| 1326553736 | Believe Neuro-behavioral Services | Behavioral Analyst | 6700 Sw 38th St, Miami, FL 33155 | 2017-12-07 |
| Find all providers in zip 33155 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801327564 | Paola Granados-radlick | Psychologist | 1200 Brickell Ave Ste 850, Miami, FL 33131-3212 | 2017-03-24 |
| 1205388527 | Safe Landing, Inc | Psychologist | 9200 Nw 8th Ave, Miami, FL 33150-2016 | 2016-11-03 |
| 1295083376 | Carolina Avila | Psychologist | 1695 Nw 9th Ave Ste 2516, Miami, FL 33136-1409 | 2012-08-21 |
| 1114252947 | Mercedes C. Garcia | Psychologist | 14221 Sw 120th St Ste 118, Miami, FL 33186-7463 | 2009-10-13 |
| 1144485673 | Daniel Marc Bagner | Psychologist | 11200 Sw 8th St Fiu Center for Children and Families, Miami, FL 33199-2659 | 2008-07-24 |
| 1437327129 | Magalis Aguilera | Psychologist | 9745 Sunset Dr, Suite 218, Miami, FL 33173-4652 | 2008-02-14 |
| 1275751125 | Susan Rose Chalfin | Psychologist | 1695 Nw 9th Avenue, Room 1517a, Miami, FL 33136 | 2007-04-23 |
| 1396222840 | Marina Villani Capo | Psychologist | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2018-07-26 |
| 1740714948 | Eileen Matias Davis | Psychologist | 1601 Nw 12th Ave, Suite 4059, Miami, FL 33136-1005 | 2017-04-13 |
| 1730624818 | Susan Acosta, Phd | Psychologist | 7700 N Kendall Dr, Miami, FL 33156-7564 | 2016-12-28 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.