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NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
NPI 1063966901
Radiology - Pediatric Radiology in Miami, FL

Active since August 09, 2016CLIA 10D2311192 · Waiver
3100 SW 62ND AVE, 1ST FLOOR, SUITE B- DEPARTMENT OF RADIOLOGY, MIAMI, FL 33155(786) 624-5876(786) 624-2688 Get Directions Write a Review

NPPES record last updated: April 9, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 9, 2025, Nov 6, 2024, Mar 3, 2021 and 4 more (7 updates tracked since 2016).

About Nicklaus Children's Pediatric Specialists, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC (NPI 1063966901), doing business as Nicklaus Children's Pediatric Specialists - Radiology, is a healthcare organization registered as a pediatric radiology in Miami, Florida and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through September 17, 2026 and lists Marcos Mestre, Svp, as its authorized official.

NPPES Registry Identity

NPI1063966901
Entity TypeOrganization
Primary Taxonomy2085P0229X
Legal Business NameNICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Location Address3100 SW 62ND AVE, 1ST FLOOR, SUITE B- DEPARTMENT OF RADIOLOGYMiami, FL 33155
Mailing AddressPo Box 947095Atlanta, GA 30394-7095
Phone(786) 624-5876
Fax(786) 624-2688
Organization SubpartNo
Authorized OfficialMarcos MestreSvp · (305) 666-6511
Enumeration DateAugust 9, 2016
Last NPPES UpdateApril 9, 20257 updates tracked since enumeration
NPPES CertifiedApril 9, 2025
✔ NPI 1063966901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Pediatric RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085P0229X
Definition
A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.
3100 SW 62ND AVE, Miami, FL 33155
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Other Names 1

Doing Business AsNicklaus Children's Pediatric Specialists - Radiology

Other Identifiers 1

Medicaid013515214FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2311192

Nicklaus Children's Pediatric Specialists LLC · Miami, FL
Active · expires Sep 17, 2026
CLIA Number10D2311192
Laboratory TypePhysician Office
Certificate Effective DateSeptember 18, 2024
Certificate Expiration DateSeptember 17, 2026
Laboratory DirectorAdriana Carrillo Iregui
Laboratory Phone(305) 662-8368
Laboratory LocationNicklaus Children's Pediatric Specialists LLC3100 SW 62nd Ave Suite 102, Miami, FL 33155
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICE NEIL PA-C
Physician Assistant (Medical)
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (305) 666-6511
NICKLAUS CHILDREN'S PEDIATRIC SPECIALISTS, LLC
Pediatrics (Pediatric Cardiology)
3100 SW 62ND AVE, 2ND FLOOR, SUITE A- DEPARTMENT OF CARDIOLOGY
MIAMI, FL 33155
Miami-Dade County (786) 624-5876
LUCILA SERVITJE AZCARRAGA MD
Student in an Organized Health Care Education/Training Program
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (305) 669-5873
DR. YELENA SLOBODSCOY IGNATOV BSC, MD
Student in an Organized Health Care Education/Training Program
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (305) 669-5873
SIVANESAN SIVAGNANA GANESAN
Student in an Organized Health Care Education/Training Program
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (786) 624-2855
HIMANSHU MEENA
Student in an Organized Health Care Education/Training Program
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (305) 669-5873
DR. TERESITA FOX M.D.
Pediatrics
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (561) 624-9188
MRS. ERIN HERNANDEZ CPNP
Nurse Practitioner (Pediatrics)
3100 SW 62ND AVE
MIAMI, FL 33155
Miami-Dade County (305) 662-8357

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicklaus Children's Pediatric Specialists, LLC's NPI number?

The NPI number for Nicklaus Children's Pediatric Specialists, LLC is 1063966901. It was assigned to this organization in the NPPES registry on August 9, 2016. The provider is doing business as Nicklaus Children's Pediatric Specialists - Radiology.

Where is Nicklaus Children's Pediatric Specialists, LLC located?

Nicklaus Children's Pediatric Specialists, LLC is located at 3100 SW 62nd Ave 1st Floor, Suite B- Department Of Radiology, Miami, FL 33155. The listed phone number is (786) 624-5876.

What is Nicklaus Children's Pediatric Specialists, LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Pediatric Radiology, with taxonomy code 2085P0229X.

Does Nicklaus Children's Pediatric Specialists, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2311192) is associated with this NPI, valid through September 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Nicklaus Children's Pediatric Specialists, LLC accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) and 1 other insurer list Nicklaus Children's Pediatric Specialists, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Nicklaus Children's Pediatric Specialists, LLC was last updated on April 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.