MEDICARE: KIDSVILLE PEDIATRICS I, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician
2	208D00000X	General Practice Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GV270A	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780658294
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDSVILLE PEDIATRICS I, P.A.

Provider Business Mailing Address
First Line	:	2201 NORTH BLVD W
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-8990
Country	:	US
Telephone Number	:	863-419-0688
Fax Number	:	863-419-9547

Provider Business Practice Location Address
First Line	:	2201 NORTH BLVD W
Second Line	:
City	:	DAVENPORT
State	:	FL
Zip	:	33837-8990
Country	:	US
Telephone Number	:	863-419-0688
Fax Number	:	863-419-9547

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. VICTOR M. PANTOJA JR.
Credential	:
Telephone Number	:	863-419-0688

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	01/22/2025

Similar Medicare Providers

1255297164 — LEICY MARIBI GRANADILLO CARROZ
Practice Location Address:

2243 NORTH BLVD W
DAVENPORT, FL
33837-8990

Practice Phone: 863-270-1339
Practice Fax:

1841294501 — DR. PAUL MICHAEL ARNOLD M.D.
Practice Location Address:

2217 NORTH BLVD W
DAVENPORT, FL
33837-8990

Practice Phone: 863-421-3456
Practice Fax: 863-421-3466

1992700363 — DR. CLAUDIO MANUBENS M.D.
Practice Location Address:

2239 NORTH BLVD W
DAVENPORT, FL
33837-8990

Practice Phone: 407-645-1847
Practice Fax: 321-274-0246

1457330359 — BOBBILYNN HAWKINS MD
Practice Location Address:

2217 NORTH BLVD W
DAVENPORT, FL
33837-8990

Practice Phone: 863-421-3456
Practice Fax: 863-421-3466

1417917618 — FELIX U BIGAY-RODRIGUEZ M.D.
Practice Location Address:

2221 NORTH BLVD W
DAVENPORT, FL
33837-8990

Practice Phone: 863-421-7600
Practice Fax:

1528010535 — MARK ALKASS MD
Practice Location Address:

2221 NORTH BLVD W
DAVENPORT, FL
33837-8990

Practice Phone: 863-421-7600
Practice Fax: 863-421-7551

Directions to “KIDSVILLE PEDIATRICS I, P.A. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.