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FAMILY TREE MEDICAL GROUP II, PA
NPI 1720727654
General Practice in Davenport, FL

Active since May 31, 2022CLIA 10D2261587 · Waiver
2201 NORTH BLVD W, DAVENPORT, FL 33837(863) 353-1246(863) 419-9547 Get Directions Write a Review

NPPES record last updated: December 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Family Tree Medical Group Ii, Pa NPPES

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

FAMILY TREE MEDICAL GROUP II, PA (NPI 1720727654) is a healthcare organization registered as a general practice in Davenport, Florida and active in the NPI registry since May 2022. The organization holds a CLIA Waiver certificate valid through June 1, 2028 and lists Victor M Pantoja, Buisness Owner, as its authorized official.

NPPES Registry Identity

NPI1720727654
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameFAMILY TREE MEDICAL GROUP II, PA
Location Address2201 NORTH BLVD WDavenport, FL 33837-8990
Mailing Address2201 North Blvd WDavenport, FL 33837-8990 · (863) 353-1246 · Fax (863) 419-9547
Phone(863) 353-1246
Fax(863) 419-9547
Organization SubpartNo
Authorized OfficialVictor M PantojaBuisness Owner · (407) 970-2981
Enumeration DateMay 31, 2022
Last NPPES UpdateDecember 14, 2022
NPPES CertifiedDecember 14, 2022
✔ NPI 1720727654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
Also ListedPediatricsTaxonomy 208000000X
2201 NORTH BLVD W, Davenport, FL 33837
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 10D2261587

Family Tree Medical Group II, PA · Davenport, FL
Active · expires Jun 1, 2028
CLIA Number10D2261587
Laboratory TypePhysician Office
Certificate Effective DateJune 2, 2026
Certificate Expiration DateJune 1, 2028
Laboratory DirectorFrancelis I. Gonzalez
Laboratory Phone(407) 970-2981
Laboratory LocationFamily Tree Medical Group II, PA2201 North Blvd West, Davenport, FL 33837
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 4

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

EILEEN J RUIZ ARNP
Nurse Practitioner (Primary Care)
2201 NORTH BLVD W
DAVENPORT, FL 33837
Polk County (863) 419-0688
KIDSVILLE PEDIATRICS VII, P.A. AFTER HOURS WALK-IN CLINIC
Pediatrics
2201 NORTH BLVD W
DAVENPORT, FL 33837
Polk County (863) 419-0688
KIDSVILLE PEDIATRICS I, P.A.
General Practice
2201 NORTH BLVD W
DAVENPORT, FL 33837
Polk County (863) 419-0688
ANTONIO QUINONES APRN
Nurse Practitioner (Family)
2201 NORTH BLVD W
DAVENPORT, FL 33837
Polk County (863) 419-0688

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 Family Tree Medical Group II, PA's NPI number?

The NPI number for Family Tree Medical Group II, PA is 1720727654. It was assigned to this organization in the NPPES registry on May 31, 2022.

Where is Family Tree Medical Group II, PA located?

Family Tree Medical Group II, PA is located at 2201 North Blvd W, Davenport, FL 33837. The listed phone number is (863) 353-1246.

What is Family Tree Medical Group II, PA's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does Family Tree Medical Group II, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2261587) is associated with this NPI, valid through June 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Tree Medical Group II, PA was last updated on December 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.