MEDICARE: PEDIATRIX MEDICAL GROUP OF GEORGIA, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician

General Provider Information

NPI Number	:	1144172545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDIATRIX MEDICAL GROUP OF GEORGIA, P.C.

Provider Business Mailing Address
First Line	:	1301 CONCORD TER
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-2843
Country	:	US
Telephone Number	:	800-243-3839
Fax Number	:

Provider Business Practice Location Address
First Line	:	677 CHURCH ST NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-1101
Country	:	US
Telephone Number	:	770-793-5000
Fax Number	:

Authorized Official
Title or Position	:	ASSISTANT SECRETARY
Name	:	NICHOLAS E GLASER
Credential	:
Telephone Number	:	800-243-3839

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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