Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatrix Medical Group of Florida Inc

Organization Plastic Surgery Physician · NPI 1154056109

Pediatrix Medical Group of Florida Inc is a Plastic Surgery Physician in Port St Lucie, Florida. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1850 SW Fountainview Blvd Ste 201
Port St Lucie, FL 34986-4527
Phone: (800) 243-3839
Fax: (855) 527-5510
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X
Plastic Surgery Physician Taxonomy 208200000X
Pediatric Surgery Physician Taxonomy 2086S0120X
Pediatric Urology Physician Taxonomy 2088P0231X

Record details

NPI number1154056109
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nicholas Glaser — President · (800) 243-3839
NPI enumeratedJuly 22, 2022
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024
Mailing address1301 Concord Ter, Sunrise, FL 33323-2843

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