PEDIATRIC SPECIALTY GROUP, INC. (NPI# 1588118426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588118426 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC SPECIALTY GROUP, INC. |
| Other Organization Name | PEDIATRIC SPECIALISTS OF AMERICA- CARDIOVASCULAR SURGERY |
| Practice Address |
3100 Sw 62nd Ave 2nd Floor-suite B- Department of Cardiovascular Surgery Miami FL 33155 |
| Mailing Address |
Po Box 865095 Orlando FL 32886-5095 |
| Practice Telephone | 7866245876 |
| Practice Fax Number | 7866242688 |
| Mailing Telephone | 7866245876 |
| Mailing Fax Number | 7866242688 |
| Enumeration Date | 2016-08-09 |
| Last Update Date | 2018-06-11 |
| Authorized Official Name | ELIZABETH MENOCAL (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 3056628357 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 013515204 | 05 |
| Other Name | Type Code |
|---|---|
| Pediatric Specialists of America- Cardiovascular Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316589914 | Pediatric Specialty Group, Inc. | Pediatrics | 9750 Nw 33rd St Ste 109, Coral Springs, FL 33065-4000 | 2019-10-15 |
| 1457965345 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-09-08 |
| 1306459177 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1235774852 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, 1st Floor, Trauma Unit, Miami, FL 33155-3009 | 2019-11-07 |
| 1124553656 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Apcp- 6 Tower, Suite 6226, Miami, FL 33155-3009 | 2017-04-21 |
| 1881128171 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Palliative Care Medicine- 3rd Floor- Suite 6-74, Miami, FL 33155 | 2017-04-13 |
| 1194277756 | Pediatric Specialty Group, Inc. | Psychologist | 3100 Sw 62nd Ave, Department of Psychology, Miami, FL 33155-3009 | 2016-10-31 |
| 1528512001 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Department of Gastroenterology, Miami, FL 33155 | 2016-08-12 |
| 1891249371 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave Ste 102, Miami, FL 33155 | 2016-08-12 |
| 1982158820 | Pediatric Specialty Group, Inc. | Ophthalmology | 3100 Sw 62nd Ave, Miami, FL 33155 | 2016-08-09 |
| Street Address |
3100 SW 62ND AVE 2ND FLOOR-SUITE B- DEPARTMENT OF CARDIOVASCULAR SURGERY |
| City | MIAMI |
| State | FL |
| Zip Code | 33155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824077 | Rene Luis Lopez-guerrero | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2005-07-13 |
| 1598366239 | Alejandra Margarita Patterson | Registered Nurse | 3100 Sw 62nd Ave, Suite 108 Center for Spinal Disorders, Miami, FL 33155 | 2020-11-07 |
| 1093315947 | Mailys Santoro | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-29 |
| 1174121289 | Lilia M Mendoza | Family Medicine | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-12 |
| 1932707007 | Brian Ruiz | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-10-12 |
| 1457965345 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-09-08 |
| 1306459177 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1568075372 | Nancy Pierre | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-31 |
| 1841803335 | Dicle Yasar Aksoyler | Student in an Organized Health Care Education/Training Program | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-25 |
| 1154932952 | Veronica A Quintanar Sanabria | Nurse Practitioner | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2020-08-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987121 | Blanca Argentina Torres | Speech-Language Pathologist | 6840 Bird Rd Unit 211a, Miami, FL 33155 | 2020-09-21 |
| 1245888585 | Mila De La Caridad Broche Coego | Behavior Technician | 2247 Sw 68th Ct, Miami, FL 33155 | 2019-08-29 |
| 1265087878 | Nancy Acela Denis | Nurse Practitioner | 6791 Sw 25 Terra, Miami, FL 33155 | 2019-08-09 |
| 1700366887 | Aly Hashim | Family Medicine | 2805 Sw 75th Avenue, Miami, FL 33155 | 2018-08-17 |
| 1184115362 | Ready 2 Transfer, Inc. | Non-emergency Medical Transport (VAN) | 7811 Sw 24 Street #120, Miami, FL 33155 | 2018-05-23 |
| 1053808030 | Idalmis Pimentel Diez | Behavior Technician | 6334 Sw 30th St, Miami, FL 33155 | 2018-04-16 |
| 1225538689 | L & L Social Services LLC | Case Management | 5950 Sw 40 St, Miami, FL 33155 | 2018-02-12 |
| 1659888915 | Red Bird Dental Care | Dentist | 5771 Sw 40 St, Miami, FL 33155 | 2018-01-08 |
| 1043726474 | Jesenia Rodriguez-vila | Nurse Practitioner | 6433 Sw 29th St, Miami, FL 33155 | 2017-12-21 |
| 1326553736 | Believe Neuro-behavioral Services | Behavioral Analyst | 6700 Sw 38th St, Miami, FL 33155 | 2017-12-07 |
| Find all providers in zip 33155 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437765898 | Leonardo Andrade Mulinari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1120 Nw 14th St Ofc 462, Miami, FL 33136-2107 | 2020-09-21 |
| 1124410857 | Miami Vein Clinics Pllc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 8549 Coral Way, Miami, FL 33155-2335 | 2015-03-04 |
| 1629034251 | Beethoven Brown | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3661 South Miami Avenue, Suite 402, Miami, FL 33145 | 2006-04-22 |
| 1285621243 | Roger G. Carrillo | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1295 Nw 14th St, Suite H, Miami, FL 33125-1610 | 2005-10-04 |
| 1396357893 | Joao Roberto Breda | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1801 Nw 9th Ave Fl 5, Miami, FL 33136-1125 | 2020-08-18 |
| 1770080327 | Charleston Cardiac Surgery Ass | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3270 Nw 36th St, Miami, FL 33142-5036 | 2018-04-10 |
| 1821449034 | Naaman Abdullah Md Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4770 Biscayne Blvd, Suite 860, Miami, FL 33137-3202 | 2016-06-29 |
| 1790144368 | Naaman Abdullah Md Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4770 Biscayne Blvd, Suite 860, Miami, FL 33137-3202 | 2016-02-11 |
| 1902141245 | Vicente Orozco -sevilla | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1611 Nw 12 Avenue, Room 3072- Jackson Memorial - Holtz Center, Miami, FL 33125 | 2012-11-27 |
| 1386917292 | International Surgical and Medical Associates, LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4770 Biscayne Blvd, Suite 880, Miami, FL 33137-3202 | 2012-02-23 |
| Find all providers in MIAMI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.