Organization
KIDSVILLE PEDIATRICS I, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR M. PANTOJA JR. (ADMINISTRATOR)
(863) 419-0688
Entity
Organization
Contact information
Practice address
2201 NORTH BLVD W, DAVENPORT, FL 33837-8990
(863) 419-0688
(863) 419-9547
Mailing address
2201 NORTH BLVD W, DAVENPORT, FL 33837-8990
(863) 419-0688
(863) 419-9547
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
265713900
—
FL
01
—
GV270A
MEDICARE
FL
Enumeration date
02/14/2006
Last updated
01/22/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us