Organization
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Active
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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