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Organization

NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

Active
Other names
Nicklaus Children's at Davie
Organization subpart
No

Provider details

NPI number
Authorized official
MARCOS MESTRE MD (SVP)
(305) 666-6511
Entity
Organization

Contact information

Practice address
10230 W STATE ROAD 84, DAVIE, FL 33324-4202
(305) 666-6511
Mailing address
PO BOX 947095, ATLANTA, GA 30394-7095

Taxonomy

Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
207YP0228X
Pediatric Otolaryngology Physician
2080P0202X
Pediatric Cardiology Physician
Primary
2080P0206X
Pediatric Gastroenterology Physician
208200000X
Plastic Surgery Physician
2084N0400X
Neurology Physician
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
11/05/2024
Last updated
11/05/2024
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