PEDIATRIC SPECIALTY GROUP, INC. (NPI# 1982158820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982158820 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALTY GROUP, INC. |
| Other Organization Name | PEDIATRIC SPECIALISTS OF AMERICA- OPHTHALMOLOGY |
| Practice Address |
3100 Sw 62nd Ave 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 | 2018-09-11 |
| 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 | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 013515213 | 05 |
| Other Name | Type Code |
|---|---|
| Pediatric Specialists of America- Ophthalmology | 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 |
| 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 |
| 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 | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902368053 | Eye Hope Clinic LLC | Ophthalmology | 9655 S Dixie Hwy Ste 102, Miami, FL 33156-2813 | 2019-04-05 |
| 1174032148 | New America Diagnositcs Center Inc | Ophthalmology | 2470 Sw 137th Avenu, Miami, FL 33175 | 2017-09-21 |
| 1922531144 | Hacer Isildak | Ophthalmology | 1638 Nw 10th Ave, Mcknight Bldg. Suite 110, Miami, FL 33136-1015 | 2017-04-05 |
| 1235682311 | Carlos Ernesto Mendoza Santiesteban | Ophthalmology | 900 Sw 17th St, Miami, FL 33136 | 2016-07-26 |
| 1063838233 | Retina Macula Specialists of Miami | Ophthalmology | 351 Nw 42nd Ave Ste 501, Miami, FL 33126-5690 | 2014-03-12 |
| 1609290279 | South Florida Eye Associates, Pa | Ophthalmology | 5757 Blue Lagoon Dr, Suite 240, Miami, FL 33126-2058 | 2014-02-18 |
| 1154763506 | Jorge Gabreil Lazcano | Ophthalmology | 4444 Sw 71st Ave, Miami, FL 33155-4667 | 2013-07-26 |
| 1659634939 | Mario Joseph Rojas | Ophthalmology | 951 South Lejeune Rd Suite 200, Miami, FL 33134 | 2012-06-21 |
| 1346509890 | Paul D Baciu | Ophthalmology | 900 Nw 17th Street, Miami, FL 33136 | 2012-05-03 |
| 1487912275 | Stanley Spielman | Ophthalmology | 7950 Sw 125th St, Miami, FL 33156-6061 | 2012-04-30 |
| 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.