Organization
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Active
Other names
Nicklaus Children's Pediatric Specialists - Adolescent Medicine
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, SUITE 109, MIAMI, FL 33155
(786) 624-5876
(786) 624-2688
Mailing address
PO BOX 947095, ATLANTA, GA 30394-7095
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013515203
—
FL
Enumeration date
08/09/2016
Last updated
02/12/2025
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