PEDIATRIC SPECIALTY GROUP, INC. (NPI# 1306459177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306459177 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALTY GROUP, INC. |
| Practice Address |
3100 Sw 62nd Ave Miami FL 33155-3009 |
| Practice Telephone | 3056628301 |
| Practice Fax Number | 3056628304 |
| Mailing Telephone | 3056628301 |
| Mailing Fax Number | 3056628304 |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |
| Authorized Official Name | LAURA M GABER (PROVIDER RELATIONS SPECIALIST) |
| Authorized Official Telephone | 7866245747 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pediatric Specialists of America - Interventional Cardiology | Doing Business As Name - 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 |
| 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 |
| 1194277756 | Pediatric Specialty Group, Inc. | Psychologist | 3100 Sw 62nd Ave, Department of Psychology, Miami, FL 33155-3009 | 2016-10-31 |
| 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 |
| 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 |
| 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 |
| 1477161321 | Sarah Kathryn Kenis | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-07-16 |
| 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 | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114425477 | Cardiac Cin of Miami LLC | Internal Medicine | 2 S Biscayne Blvd Ste 3760c, Miami, FL 33131-1815 | 2018-01-31 |
| 1386034205 | Soteria Medical, LLC | Internal Medicine | 9150 Sw 87th Avenue, 213, Miami, FL 33176-2313 | 2015-01-30 |
| 1609266790 | Unicardio Medical Center Corp | Internal Medicine | 61 Grand Canal Dr Ste 200, Miami, FL 33144-2554 | 2015-01-28 |
| 1386900637 | Camilo Andres Gomez | Internal Medicine | 1611 Nw 12 Ave Central Building, Room 600d (r-60), Miami, FL 33136 | 2012-04-11 |
| 1295006435 | Stronghealth Network Pllc | Internal Medicine | 815 Nw 57th Ave Ste 130, Miami, FL 33126-2041 | 2012-01-19 |
| 1790968683 | Miami Heart Center Inc | Internal Medicine | 1990 Sw 27th Ave, 2nd Floor, Miami, FL 33145-2547 | 2007-12-13 |
| 1710994736 | Alvaro Agusto Gomez | Internal Medicine | 7400 Sw 87 Avenue, Suite #100, Miami, FL 33173 | 2006-08-02 |
| 1760497507 | Ramon Luis Lloret | Internal Medicine | 7400 Sw 87th Avenue, Suite 100, Miami, FL 33173 | 2006-07-30 |
| 1992719074 | Walter Osvaldo Ramirez | Internal Medicine | 11760 Sw 40th St Ste 622a, Miami, FL 33175-3582 | 2006-07-27 |
| 1588614572 | Juan C Cueto | Internal Medicine | 4150 Nw 7th St, Suite 100, Miami, FL 33126-5535 | 2006-05-11 |
| 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.