NPIMap

Organization Active NPI

Pediatrix Medical Group of Florida Inc

  • Pediatric Cardiology Physician
  • Mangonia Park, FL
National Provider Identifier
1902475122
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
PEDIATRIX MEDICAL GROUP OF FLORIDA INC
Practice address
901 45TH St
Mangonia Park, FL 33407-2413
Phone
(561) 844-6300
Fax
(855) 527-5510
NPI assigned
Jun 22, 2021
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Nicholas E Glaser
Title
President
Phone
(800) 243-3839

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X Primary
Pediatric Endocrinology Physician 2080P0205X
Plastic Surgery Physician 208200000X
Pediatric Surgery Physician 2086S0120X
Pediatric Urology Physician 2088P0231X

Addresses

Primary practice location

901 45TH St
Mangonia Park, FL 33407-2413

Mailing address

1301 Concord Ter
Sunrise, FL 33323-2843
Phone (800) 243-3839

Other identifiers 1

IdentifierTypeStateIssuer
060035143MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Pediatrix Medical Group of Florida Inc252 organizations share this tax ID, including this one

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": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1902475122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CONCORD TER",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232843",
            "telephone_number": "800-243-3839",
            "fax_number": "855-527-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 45TH ST",
            "city": "MANGONIA PARK",
            "state": "FL",
            "postal_code": "334072413",
            "telephone_number": "561-844-6300",
            "fax_number": "855-527-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP OF FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-243-3839"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060035143",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mangonia Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.