Provider Demographics
NPI:1902694896
Name:TMG PEDIATRICS LLC
Entity type:Organization
Organization Name:TMG PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIZAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-709-4978
Mailing Address - Street 1:11904 MIRAMAR PKWY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7005
Mailing Address - Country:US
Mailing Address - Phone:561-709-4978
Mailing Address - Fax:561-210-7540
Practice Address - Street 1:11904 MIRAMAR PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7005
Practice Address - Country:US
Practice Address - Phone:561-709-4978
Practice Address - Fax:561-210-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty