Pediatric Medicine Associates Group Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME48450 Issued in FL

Legal business name

PEDIATRIC MEDICINE ASSOCIATES GROUP INC.

Practice address

10820 NW 58TH St
Doral, FL 33178-2854

Phone

(305) 477-7111

Fax

(305) 594-3126

NPI assigned

Mar 2, 2007

Last updated

Nov 16, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jorge A De DiegoNPI 1386784684

Title

MD

Phone

(305) 477-7111

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jorge Alberto De Diego, M.D

  • Pediatrics Physician
  • Doral, FL
  • NPI 1386784684
  NPD Authorized official

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1811026354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10820 NW 58TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782854",
            "telephone_number": "305-477-7111",
            "fax_number": "305-594-3126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10820 NW 58TH ST",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331782854",
            "telephone_number": "305-477-7111",
            "fax_number": "305-594-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICINE ASSOCIATES GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "DE DIEGO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "305-477-7111"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME48450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106861000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811026354",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Jax (South Florida Center for Behavioral Health)
• Peaceful Life Psychiatric, LLC
• Peaceful Progress Miami, LLC
• Jose Arturo Peaguda Sr.
• Latresha Pearce, OTR/L
• Pediatrix Medical Group of Florida Inc
• Pediatrix Medical Group of Florida Inc
• Bania Pedraja Fuentes
• Sandramilena Pedraza Garzon
• Pedro Martinez-Clark MD PA

• Pediatrics Physician in Doral, FL
• Providers in Doral, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.