PEDIATRIC SPECIALTY GROUP, INC. (NPI# 1487108320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487108320 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALTY GROUP, INC. |
| Other Organization Name | PEDIATRIC SPECIALISTS OF AMERICA - ADOLESCENT MEDICINE |
| Practice Address |
3100 Sw 62nd Ave Suite 109 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 | 2018-06-11 |
| Authorized Official Name | ELIZABETH MENOCAL (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3056628357 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 013515203 | 05 |
| Other Name | Type Code |
|---|---|
| Pediatric Specialists of America - Adolescent Medicine | 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 |
| 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 |
| Street Address |
3100 SW 62ND AVE SUITE 109 |
| City | MIAMI |
| State | FL |
| Zip Code | 33155 |
| 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 | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710330923 | Juan Ruiz-unger Md Pa | Pediatrics | 8900 Sw 24th St Ste 204, Miami, FL 33165-2075 | 2016-07-22 |
| 1689064750 | Hilda Tejero | Pediatrics | 9495 Sunset Dr Ste B190, Miami, FL 33173-5419 | 2015-01-28 |
| 1043337033 | Saara Schwartz | Pediatrics | Fiu-university Health Services, 11200 Sw 8th St, Miami, FL 33199-0001 | 2007-03-23 |
| 1760506752 | Cristykids Pediatrics | Pediatrics | 8496 Sw 8th St, Miami, FL 33144-4153 | 2007-03-17 |
| 1346374212 | Isidro A Lopez | Pediatrics | 1495 Nw 20th St, Miami, FL 33142-7723 | 2007-03-15 |
| 1235260761 | South Miami Pediatries | Pediatrics | 9745 Sw 184th St, Miami, FL 33157-6932 | 2007-03-08 |
| 1942286778 | Diana E Vargas | Pediatrics | 10250 Sw 56th St, Ste. B-103, Miami, FL 33165-7069 | 2005-12-22 |
| 1720077308 | Guillermo Juan Llosa | Pediatrics | 11400 N Kendall Dr, Suite A211, Miami, FL 33176-1029 | 2005-10-17 |
| 1912993312 | Ana Roig-cantisano | Pediatrics | 9220 Sw 72nd St, Suite 102, Miami, FL 33173-3259 | 2005-09-21 |
| 1679006761 | Alvarez Diaz Pediatrics Corp | Pediatrics | 7235 Coral Way Ste 214, Miami, FL 33155-1452 | 2017-04-06 |
| 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.