Organization
KIDSVILLE PEDIATRICS II, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR M. PANTOJA JR. (ADMINISTRATOR)
(407) 518-0078
Entity
Organization
Contact information
Practice address
1050 W CARROLL ST, KISSIMMEE, FL 34741-1268
(407) 518-0078
(407) 518-0094
Mailing address
1050 W CARROLL ST, KISSIMMEE, FL 34741-1268
(407) 518-0078
(407) 518-0094
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME-0074421
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274049400
—
FL
Enumeration date
02/07/2006
Last updated
08/13/2019
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