Provider Type Icon

PEDIATRIC SPECIALTY GROUP INC. NPI 1669926507


NPI Information

NPI: 1669926507
Provider Name: PEDIATRIC SPECIALTY GROUP, INC.

Doing Business As: NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS - ALLERGY AND IMMUNOLOGY

Classification: Pediatrics - 2080P0201X
Entity Type: Organization

Specialization: Pediatric Allergy/Immunology

Address:
3100 SW 62ND AVE
3RD FLOOR- 3NE WING
MIAMI, FL
ZIP 33155
Phone: (786) 624-5876
Get Directions

PEDIATRIC SPECIALTY GROUP, INC. is a pediatric allergy/immunology pediatrics in Miami, FL. The provider is a pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. PEDIATRIC SPECIALTY GROUP, INC. NPI is 1669926507. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Nicklaus Children's Pediatric Specialists - Allergy And Immunology.

The provider's business location address is:

3100 SW 62ND AVE
3RD FLOOR- 3NE WING
MIAMI, FL
ZIP 33155
Phone: (786) 624-5876
Fax: (786) 624-2688

The provider's authorized official is Laura M Gaber .
The authorized official title is Provider Relations Specialist and has the following contact phone number (786) 624-5747.

The enumeration date for this NPI number is 8/9/2016 and was last updated on 3/3/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207K00000XAllergy & ImmunologyNo
22080P0201XPediatricsPediatric Allergy/ImmunologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1013515202MEDICAIDFLORIDA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.