Organization
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Active
Organization
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Active
Other names
Nicklaus Children's Pediatric Specialists - Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS MESTRE (SVP)
(305) 666-6511
Entity
Organization
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(305) 666-6511
(305) 662-8291
Mailing address
PO BOX 947095, ATLANTA, GA 30394-7095
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
—
—
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
—
—
Other
Enumeration date
02/17/2022
Last updated
04/09/2025
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