Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Pediatrix Medical Group Ambulatory Services of Tn, PLLC

Organization Obstetrics & Gynecology Physician · NPI 1063110880

Pediatrix Medical Group Ambulatory Services of Tn, PLLC is an Obstetrics & Gynecology Physician in Sunrise, Florida. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
11
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1301 Concord Ter
Sunrise, FL 33323-2843
Phone: (800) 243-3839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Maternal & Fetal Medicine Physician (primary) Taxonomy 207VM0101X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Pediatrics Physician Taxonomy 208000000X
Pediatric Cardiology Physician Taxonomy 2080P0202X
Pediatric Critical Care Medicine Physician Taxonomy 2080P0203X
Pediatric Gastroenterology Physician Taxonomy 2080P0206X
Pediatric Infectious Diseases Physician Taxonomy 2080P0208X
Pediatric Pulmonology Physician Taxonomy 2080P0214X
Pediatric Surgery Physician Taxonomy 2086S0120X
Acute Care Nurse Practitioner Taxonomy 363LA2100X
Women's Health Nurse Practitioner Taxonomy 363LW0102X

Record details

NPI number1063110880
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Ashford — Assistant Secretary · (800) 243-3839
NPI enumeratedFebruary 21, 2023
Last updated in NPPESAugust 5, 2025
Certification dateAugust 5, 2025
Mailing addressPo Box 100445, Atlanta, GA 30384-0445

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