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KIDSVILLE PEDIATRICS II, P.A.
NPI 1144292756
Pediatrics in Kissimmee, FL

Active since February 07, 2006CLIA 10D1007087 · Waiver
1050 W CARROLL ST, KISSIMMEE, FL 34741(407) 518-0078(407) 518-0094 Get Directions Write a Review

NPPES record last updated: August 13, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kidsville Pediatrics Ii, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIDSVILLE PEDIATRICS II, P.A. (NPI 1144292756) is a healthcare organization registered as a pediatrics in Kissimmee, Florida and active in the NPI registry since February 2006. The organization holds a CLIA Waiver certificate valid through December 8, 2026, maintains a secondary practice location in Kissimmee, and lists Victor M. Pantoja Jr., Administrator, as its authorized official.

NPPES Registry Identity

NPI1144292756
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameKIDSVILLE PEDIATRICS II, P.A.
Location Address1050 W CARROLL STKissimmee, FL 34741-1268
Mailing Address1050 W Carroll StKissimmee, FL 34741-1268 · (407) 518-0078 · Fax (407) 518-0094
Phone(407) 518-0078
Fax(407) 518-0094
Organization SubpartNo
Authorized OfficialVictor M. Pantoja Jr.Administrator · (407) 518-0078
Enumeration DateFebruary 7, 2006
Last NPPES UpdateAugust 13, 2019
✔ NPI 1144292756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in FL · ME-0074421
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1050 W CARROLL ST, Kissimmee, FL 34741
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Secondary Practice Location 1

Location 11050 W Carroll StKissimmee, FL 34741-1268 · Phone (407) 518-0078 · Fax (407) 518-0094

Other Identifiers 1

Medicaid274049400FL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL) and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1007087

Kidsville Pediatrics II PA · Kissimmee, FL
Active · expires Dec 8, 2026
CLIA Number10D1007087
Laboratory TypePhysician Office
Certificate Effective DateDecember 9, 2024
Certificate Expiration DateDecember 8, 2026
Laboratory DirectorFrancelis I. Gonzalez
Laboratory Phone(407) 518-0078
Laboratory LocationKidsville Pediatrics II PA1050 W Carroll St, Kissimmee, FL 34741
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KIDSVILLE PEDIATRICS V, P.A.
Pediatrics
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-0078
MRS. INGRID RAFAELA MURRAY P.A.
Physician Assistant (Medical)
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-0078
MS. FANY AQUINO
Physician Assistant
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-0078
VIVIAN VALENZUELA BLANCO APRN
Nurse Practitioner (Family)
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (786) 252-6747
MR. KENNETH PAUL MANSELLE PA-C
Physician Assistant (Medical)
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-9775
MR. PEDRO VAZQUEZ M.D.
Pediatrics
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-0078
MRS. MYRIAM A HERNANDEZ M.D.
Pediatrics
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-0078
DANIEL RIVERO DE JESUS M.D.
General Practice
1050 W CARROLL ST
KISSIMMEE, FL 34741
Osceola County (407) 518-0078

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kidsville Pediatrics II, P.A.'s NPI number?

The NPI number for Kidsville Pediatrics II, P.A. is 1144292756. It was assigned to this organization in the NPPES registry on February 7, 2006.

Where is Kidsville Pediatrics II, P.A. located?

Kidsville Pediatrics II, P.A. is located at 1050 W Carroll St, Kissimmee, FL 34741. The listed phone number is (407) 518-0078.

What is Kidsville Pediatrics II, P.A.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Kidsville Pediatrics II, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1007087) is associated with this NPI, valid through December 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kidsville Pediatrics II, P.A. accept?

Health plans from Ambetter Health, Ambetter of Alabama, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare and 1 other insurer list Kidsville Pediatrics II, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kidsville Pediatrics II, P.A. was last updated on August 13, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.