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KIDSVILLE PEDIATRICS I, P.A.
NPI 1780658294
General Practice in Davenport, FL

Active since February 14, 2006
2201 NORTH BLVD W, DAVENPORT, FL 33837(863) 419-0688(863) 419-9547 Get Directions Write a Review

NPPES record last updated: January 22, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 7, 2022, Aug 13, 2019, Aug 8, 2019 (3 updates tracked since 2019).

About Kidsville Pediatrics I, P.a. NPPES

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

KIDSVILLE PEDIATRICS I, P.A. (NPI 1780658294) is a healthcare organization registered as a general practice in Davenport, Florida and active in the NPI registry since February 2006. The organization lists Victor M. Pantoja Jr., Administrator, as its authorized official.

NPPES Registry Identity

NPI1780658294
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameKIDSVILLE PEDIATRICS I, P.A.
Location Address2201 NORTH BLVD WDavenport, FL 33837-8990
Mailing Address2201 North Blvd WDavenport, FL 33837-8990 · (863) 419-0688 · Fax (863) 419-9547
Phone(863) 419-0688
Fax(863) 419-9547
Organization SubpartNo
Authorized OfficialVictor M. Pantoja Jr.Administrator · (863) 419-0688
Enumeration DateFebruary 14, 2006
Last NPPES UpdateJanuary 22, 20253 updates tracked since enumeration
NPPES CertifiedJanuary 22, 2025
✔ NPI 1780658294 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
Open in Google Maps ↗

Other Identifiers 2

OtherGV270AFL · Medicare
Medicaid265713900FL

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

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
FAMILY TREE MEDICAL GROUP II, PA
General Practice
2201 NORTH BLVD W
DAVENPORT, FL 33837
Polk County (863) 353-1246
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 Kidsville Pediatrics I, P.A.'s NPI number?

The NPI number for Kidsville Pediatrics I, P.A. is 1780658294. It was assigned to this organization in the NPPES registry on February 14, 2006.

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

Kidsville Pediatrics I, P.A. is located at 2201 North Blvd W, Davenport, FL 33837. The listed phone number is (863) 419-0688.

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

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

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

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare and Wellpoint list Kidsville Pediatrics I, 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 I, P.A. was last updated on January 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months 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.