NPIMap

Organization Active NPI

Nicklaus Children'S Pediatric Specialists, LLC

  • Clinical Child & Adolescent Psychologist
  • Naples, FL
National Provider Identifier
1700765666
Registry record updated Aug 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Legal business name
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Practice address
11181 Health Park Blvd Ste 3000
Naples, FL 34110-5743
Phone
(239) 430-5559
NPI assigned
Aug 27, 2025
Organization subpart
Yes
Parent organization
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marcos Mestre
Title
SVP/Coo
Phone
(305) 666-6511

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC2200X Primary

Addresses

Primary practice location

11181 Health Park Blvd Ste 3000
Naples, FL 34110-5743

Mailing address

3100 SW 62ND Ave
Miami, FL 33155-3009

Other names 1

  • Nicklaus Children's at Naples Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Specialty Group Inc76 organizations share this tax ID, including this one
Part of
Pediatric Specialty Group Inc

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1756252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1700765666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SW 62ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331553009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11181 HEALTH PARK BLVD STE 3000",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105743",
            "telephone_number": "239-430-5559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC",
        "enumeration_date": "2025-08-27",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "MESTRE",
        "authorized_official_first_name": "MARCOS",
        "authorized_official_title_or_position": "SVP/COO",
        "authorized_official_telephone_number": "305-666-6511"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicklaus Children's at Naples",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.