Healthcare Provider Details
I. General information
NPI: 1427948488
Provider Name (Legal Business Name): PEDIATRIX MEDICAL GROUP OF FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/09/2025
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6500 W NEWBERRY RD
GAINESVILLE FL
32605-4309
US
IV. Provider business mailing address
1301 CONCORD TER
SUNRISE FL
33323-2843
US
V. Phone/Fax
- Phone: 800-243-3839
- Fax: 855-527-5510
- Phone: 800-243-3839
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LN0000X |
| Taxonomy | Neonatal Nurse Practitioner |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080N0001X |
| Taxonomy | Neonatal-Perinatal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLAS
GLASER
Title or Position: PRESIDENT
Credential:
Phone: 954-383-7267