Kidsville Pediatrics I, P.A.
NPI 1780658294ActiveOrganization· General Practice· Davenport, FL
General Practice in Davenport, 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 | 1780658294 |
|---|---|
| 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 · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 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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