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FAMILY TREE MEDICAL GROUP II PA NPI 1720727654


NPI Information

NPI: 1720727654
Provider Name: FAMILY TREE MEDICAL GROUP II, PA
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 10D2261587

Address:
2201 NORTH BLVD W
DAVENPORT, FL
ZIP 33837
Phone: (863) 353-1246
Get Directions

FAMILY TREE MEDICAL GROUP II, PA is a general practice in Davenport, FL. The provider is 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 FAMILY TREE MEDICAL GROUP II, PA NPI is 1720727654. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2201 NORTH BLVD W
DAVENPORT, FL
ZIP 33837-990
Phone: (863) 353-1246
Fax: (863) 419-9547

The provider's authorized official is Victor M Pantoja .
The authorized official title is Buisness Owner and has the following contact phone number (407) 970-2981.

The CLIA number assigned to this NPI record is 10D2261587 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/31/2022 and was last updated on 12/14/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsNo
2208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.