NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC – NPI #1063966901
Radiology

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC is a radiologist located in MIAMI, FL. NPPES has assigned the NPI number 1063966901 to NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC on August 09, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2085P0229X from the Health Care Provider Taxonomy code set, which is classified as Radiology, specializing in Pediatric Radiology

The NPI profile was last updated on Apr 09, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC below.

NPI Profile for
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

NPI Number
1063966901
Enumeration Date

(about 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Website
Primary location
3100 SW 62ND AVE
1ST FLOOR, SUITE B- DEPARTMENT OF RADIOLOGY
MIAMI, FL 33155
Phone: (786) 624-5876 Fax: (786) 624-2688
Mailing address
PO BOX 947095
ATLANTA, GA 30394-7095
Phone: Fax:
Organization Subpart
No
Authorized Official
MARCOS MESTRE
SVP
Phone: (305) 666-6511
Updated
Certification Date
Apr 09, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidFL013515214
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2085P0229X
- Radiology / Pediatric Radiology (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.