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PEDIATRIC SPECIALTY GROUP INC NPI 1003306093


NPI Information

NPI: 1003306093
Provider Name: PEDIATRIC SPECIALTY GROUP, INC

Doing Business As: NICKLAUS CHILDREN'S COCONUT CREEK CARE CENTER

Classification: Orthopaedic Surgery - 207XP3100X
Entity Type: Organization

Specialization: Pediatric Orthopaedic Surgery

Address:
6370 N STATE ROAD 7 STE 100
COCONUT CREEK, FL
ZIP 33073
Phone: (954) 321-7762
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PEDIATRIC SPECIALTY GROUP, INC is a pediatric orthopaedic surgery orthopaedic surgery in Coconut Creek, FL. The provider is an orthopedic surgeon who has additional training and experience in diagnosing, treating and managing musculoskeletal problems in infants, children and adolescents. These may include limb and spine deformities (such as club foot, scoliosis); gait abnormalities (limping); bone and joint infections; broken bones. PEDIATRIC SPECIALTY GROUP, INC NPI is 1003306093. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Nicklaus Children's Coconut Creek Care Center.

The provider's business location address is:

6370 N STATE ROAD 7 STE 100
COCONUT CREEK, FL
ZIP 33073
Phone: (954) 321-7762
Fax: (954) 321-9596

The provider's authorized official is Raiza Beatriz Vidaurrazaga .
The authorized official title is Sr. Provider Relations Specialist and has the following contact phone number (786) 624-2186.

The enumeration date for this NPI number is 5/15/2018 and was last updated on 9/26/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207T00000XNeurological SurgeryNo
2208000000XPediatricsNo
32080P0201XPediatricsPediatric Allergy/ImmunologyNo
42080P0202XPediatricsPediatric CardiologyNo
52080P0204XPediatricsPediatric Emergency MedicineNo
62080P0205XPediatricsPediatric EndocrinologyNo
72080P0206XPediatricsPediatric GastroenterologyNo
82080P0210XPediatricsPediatric NephrologyNo
92080P0216XPediatricsPediatric RheumatologyNo
10208200000XPlastic SurgeryNo
112085P0229XRadiologyPediatric RadiologyNo
12261QR0400XClinic/CenterRehabilitationNo
13261QU0200XClinic/CenterUrgent CareNo
14282NC2000XGeneral Acute Care HospitalChildrenNo
15207XP3100XOrthopaedic SurgeryPediatric Orthopaedic SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1010060900MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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