PEDIATRIC SPECIALTY GROUP, INC.


Address: 3100 Sw 62nd Ave, Suite 105, Miami, FL 33155
Phone: 7866245876

PEDIATRIC SPECIALTY GROUP, INC. (NPI# 1477007318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477007318
Entity Type Organization
Organization Name PEDIATRIC SPECIALTY GROUP, INC.
Other Organization Name PEDIATRIC SPECIALISTS OF AMERICA- RHEUMATOLOGY
Practice Address 3100 Sw 62nd Ave
Suite 105
Miami
FL 33155
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 2016-08-09
Last Update Date 2018-06-15
Authorized Official Name ELIZABETH MENOCAL (AUTHORIZED OFFICIAL)
Authorized Official Telephone 3056628357
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0216X Pediatrics
Specialization: Pediatric Rheumatology
Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 013515206 05

Other Provider/Organization Names

Other Name Type Code
Pediatric Specialists of America- Rheumatology Doing Business As Name - Organization

Other Provider IDs and Locations

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
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

Office Location

Street Address 3100 SW 62ND AVE
SUITE 105
City MIAMI
State FL
Zip Code 33155

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2080P0216X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Rheumatology

Taxonomy Definition

A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1992076681 Miami Rheumatology, LLC Pediatrics 715 Sw 73rd Ave, Miami, FL 33144-2635 2012-01-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1851508857 Kristina M Wiers-shamir Pediatrics 900 Glades Rd Ste 501, Boca Raton, FL 33431-6421 2007-05-17
1861489692 Sandra M Lawrence Pediatrics 9960 Central Park Blvd N Ste 225, Boca Raton, FL 33428-1705 2005-10-06
1982268439 Luciana Brandao Paim Marques Pediatrics 1600 Sw Archer Rd, Gainesville, FL 32610-3003 2019-04-30
1144687500 Natalie Shiff Pediatrics 1600 Sw Archer Rd, Pediatrics Immunology/rheumatology, Gainesville, FL 32610-3003 2016-01-15
1154689651 Ann Marie Szymanski Pediatrics 601 5th St S Ste 504, Saint Petersburg, FL 33701-4804 2012-05-03
1023308335 Leandra Catarina Uribe Woolnough Pediatrics 1600 Sw Archer Rd, Gainesville, FL 32610 2011-04-08
1457640344 Lauren Elizabeth Duensing Pediatrics 12591 Sorrento Rd, Pensacola, FL 32507-8754 2011-03-31
1730407107 Laisa Margarita Santiago Ramos Pediatrics 601 5th St S, St Petersburg, FL 33701-4804 2010-05-11
1558382804 Renee F. Modica Pediatrics 1600 Sw Archer Rd, Gainesville, FL 32610-3003 2006-07-22
1649206152 Diana Milojevic Pediatrics 601 5th St S, St Petersburg, FL 33701-4804 2006-06-25
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Competitor

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City MIAMI
Zip Code 33155

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Dataset Information

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.

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