# NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Nicklaus Children's Pediatric Specialists - Neonatology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013456144
- **Authorized official:** MARCOS MESTRE MD (SVP/CHIEF CLINICAL OP OFFICER-CMO)
- **Authorized official phone:** (305) 666-6511

## Contact information

- **Practice address:** 3100 SW 62ND AVE, SUITE- 4 TOWER NICU, MIAMI, FL 33155-3009
- **Practice address phone:** (305) 666-6511
- **Mailing address:** PO BOX 947095, ATLANTA, GA 30394-7095
- **Mailing address phone:** (786) 624-5712
- **Mailing address fax:** (305) 668-8059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | NULL | Yes |
| 2080N0001X | Neonatal-Perinatal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/22/2017
- **Last updated:** 11/05/2024