# NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pediatric Specialists of America - Physical Medicine and Rehablitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235774852
- **Authorized official:** MARCOS MESTRE (SVP)
- **Authorized official phone:** (305) 666-6511

## Contact information

- **Practice address:** 3100 SW 62ND AVE, 1ST FLOOR, TRAUMA UNIT, MIAMI, FL 33155-3009
- **Practice address phone:** (305) 666-6511
- **Practice address fax:** (305) 662-8291
- **Mailing address:** PO BOX 947095, ATLANTA, GA 30394-7095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | NULL | — |
| 2080P0203X | Pediatric Critical Care Medicine Physician | — | — | — |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | NULL | — |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/07/2019
- **Last updated:** 11/12/2024