Kidsville Pediatrics III, P.A.
NPI 1215901723ActiveOrganization· General Practice· Clermont, FL
General Practice in Clermont, Florida, registered in NPPES in February 2006. The authorized official on file is Victor M. Pantoja Jr., Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1215901723 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 14, 2006 |
| Last updated in NPPES | Jan 22, 2025 |
| Certified by provider | Jan 22, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Pediatrics | 208000000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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