MEDICARE: NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

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	2080H0002X	Pediatric Hospice and Palliative Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881128171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 947095
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30394-7095
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 SW 62ND AVE
Second Line	:	PALLIATIVE CARE MEDICINE- 3RD FLOOR- SUITE 6-74
City	:	MIAMI
State	:	FL
Zip	:	33155
Country	:	US
Telephone Number	:	786-624-4787
Fax Number	:	786-624-2688

Authorized Official
Title or Position	:	SVP
Name	:	MARCOS MESTRE
Credential	:
Telephone Number	:	305-666-6511

Provider Enumeration Date	:	04/13/2017
Last Update Date	:	04/09/2025

Similar Medicare Providers

1588558423 — ACCESS MEDICAL GROUP OF MIAMI MEDICARE, LLC
Practice Location Address:

701 NW 27TH AVE
MIAMI, FL
33125-3012

Practice Phone: 786-744-1900
Practice Fax: 305-760-4141

1053739250 — ANDREW SY MD
Practice Location Address:

3100 SW 62ND AVE
MIAMI, FL
33155-3009

Practice Phone: 305-662-8357
Practice Fax:

1689296386 — DR. BRYAN LIMING JAN MD
Practice Location Address:

3100 SW 62ND AVE
MIAMI, FL
33155-3009

Practice Phone: 305-666-6511
Practice Fax:

1811483811 — ABDUL WASAY KHAN
Practice Location Address:

1611 NW 12TH AVE
MIAMI, FL
33136-1005

Practice Phone: 305-355-1122
Practice Fax:

1316974066 — DR. G PATRICIA CANTWELL MD
Practice Location Address:

1601 NW 12TH AVE , BOX 016960 M851
MIAMI, FL
33101-6960

Practice Phone: 305-243-4029
Practice Fax: 305-243-8470

1669780656 — DR. AMANDA RUTH ALLADIN MBBS
Practice Location Address:

1611 NW 12TH AVE , PEDIATRIC DEPARTMENT
MIAMI, FL
33136-1005

Practice Phone: 305-585-6042
Practice Fax:

Directions to “NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.