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

NPI Status: Active since May 31, 2022

Contact Information

2201 NORTH BLVD W
DAVENPORT, FL
ZIP 33837
Phone: (863) 353-1246
Fax: (863) 419-9547

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  • Organization
  • General Practice
  • CLIA Number: 10D2261587
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 06-01-2028

About FAMILY TREE MEDICAL GROUP II, PA

This page provides the complete NPI Profile along with additional information for Family Tree Medical Group Ii, Pa, a primary care provider established in Davenport, Florida operating as a General Practice. The healthcare provider is registered in the NPI registry with number 1720727654 assigned on May 2022. The practitioner's primary taxonomy code is 208D00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. Family Tree Medical Group Ii, Pa operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Victor M Pantoja Jr. (Buisness Owner)

NPI
1720727654
Provider Name
FAMILY TREE MEDICAL GROUP II, PA
Entity Type
Organization
Location Address
2201 NORTH BLVD W DAVENPORT, FL 33837
Location Phone
(863) 353-1246
Location Fax
(863) 419-9547
Mailing Address
2201 NORTH BLVD W DAVENPORT, FL 33837
Mailing Phone
(863) 353-1246
Mailing Fax
(863) 419-9547
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-31-2022
Last Update Date
12-14-2022
Code Navigator

A primary care provider (PCP) like Family Tree Medical Group Ii, Pa sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

General Practice

Taxonomy Code
208D00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1208000000XAllopathic & Osteopathic Physicians

Pediatrics

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. VICTOR M PANTOJA JR.

Authorized Official Title
BUISNESS OWNER
Authorized Official Phone
(407) 970-2981

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2261587
Facility Type
Physician Office
Certificate Effective Date
June 02, 2026
Certificate Expiration Date
June 01, 2028
Laboratory Director
FRANCELIS I. GONZALEZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Family Tree Medical Group Ii, Pa to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1720727654, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
2
Doubled → 4
Pos 4
0
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
2
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 7 → 14 → 5 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 4 + 0 + 1 + 4 + 2 + 1 + 4 + 6 + 1 + 0 + 24 = 56

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 56 is 60. The difference is the calculated check digit.

60 - 56 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1720727654.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Pediatrics
2201 NORTH BLVD W
DAVENPORT, FL 33837
Nurse Practitioner (Primary Care)
2201 NORTH BLVD W
DAVENPORT, FL 33837
General Practice
2201 NORTH BLVD W
DAVENPORT, FL 33837
Nurse Practitioner (Family)
2201 NORTH BLVD W
DAVENPORT, FL 33837

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1720727654, enumerated as an "organization" on May 31, 2022.

The provider is located at 2201 NORTH BLVD W DAVENPORT, FL 33837 and the phone number is (863) 353-1246.

General Practice with taxonomy code 208D00000X.