Family Tree Medical Group, PA
NPI 1609243989ActiveOrganization· General Practice· Kissimmee, FL
General Practice in Kissimmee, Florida, registered in NPPES in August 2015. The authorized official on file is Victor Manuel Pantoja, CEO, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1609243989 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 21, 2015 |
| Last updated in NPPES | Oct 28, 2024 |
| Certified by provider | Oct 28, 2024 |
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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