FAMILY TREE MEDICAL GROUP, PA (NPI# 1609243989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609243989 |
| Entity Type | Organization |
| Organization Name | FAMILY TREE MEDICAL GROUP, PA |
| Practice Address |
1150 Cypress Glen Cir Kissimmee FL 34741-7560 |
| Practice Telephone | 4074833200 |
| Practice Fax Number | 4074833220 |
| Mailing Telephone | 4074833200 |
| Mailing Fax Number | 4074833220 |
| Enumeration Date | 2015-08-21 |
| Last Update Date | 2019-08-08 |
| Authorized Official Name | MR. VICTOR MANUEL PANTOJA JR. (CEO) |
| Authorized Official Telephone | 4074833200 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | IV484A | 01 |
| FL | 017306100 | 05 |
| Street Address |
1150 CYPRESS GLEN CIR |
| City | KISSIMMEE |
| State | FL |
| Zip Code | 34741-7560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154874584 | Raymond Rodriguez Negron | General Practice | 1150 Cypress Glen Cir, Kissimmee, FL 34741-7560 | 2016-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083239834 | Kathia I Torres Cintron | Occupational Therapy Assistant | 201 Park Place Blvd Kissimmee Fl 347, Kissimmee, FL 34741 | 2020-06-08 |
| 1992340046 | Zynia Spencer | Marriage & Family Therapist | 345 W. Oak St., Kissimmee, FL 34741 | 2019-11-13 |
| 1225597784 | Leila Rosado | Counselor | All Family, 120 Broadway Suite 204, Kissimmee, FL 34741 | 2019-03-14 |
| 1235610312 | Yashirah Castillo | Behavior Technician | 230 Country Blvd, Apt 6, Kissimmee, FL 34741 | 2018-08-27 |
| 1376021352 | Julio Cesar Castellanos | Nurse Practitioner | 1050 W Carroll St Apt 149, Kissimmee, FL 34741 | 2018-08-01 |
| 1245724715 | Sonia Teresa Rodriguez | Counselor | 3438 W. Vine Street, Kissimmee, FL 34741 | 2018-06-19 |
| 1700376316 | Jessica Mateo | Social Worker | 111 E Monument Ave Unit 412, Kissimmee, FL 34741 | 2018-05-18 |
| 1306340880 | George Gianakakos | Psychiatry & Neurology | 720 W. Oak St., Suite 360, Kissimmee, FL 34741 | 2018-03-20 |
| 1154825693 | Mary Catherine Slome | Student in an Organized Health Care Education/Training Program | 720 W. Oat Street, Ste. 201, Kissimmee, FL 34741 | 2018-03-20 |
| 1457855991 | Sherwin Zachariah Thomas | Student in an Organized Health Care Education/Training Program | 720 W. Oak St., Ste 201, Kissimmee, FL 34741 | 2018-03-20 |
| Find all providers in zip 34741 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043835473 | Adventist Health System Sunbelt, Inc | Family Medicine | 2488 E Irlo Bronson Memorial Hwy Ste 204, Kissimmee, FL 34744-4908 | 2020-06-11 |
| 1386268993 | Florida Advanced Medicine LLC | Family Medicine | 2522 Oak Run Blvd, Kissimmee, FL 34744-3017 | 2020-05-31 |
| 1053932202 | Willka Vanessa Parra | Family Medicine | 1997 Willow Wood Dr # De, Kissimmee, FL 34746-3780 | 2020-04-29 |
| 1053932350 | Mariana Carolina Diaz | Family Medicine | 3141 Pine Branch Dr Apt 103, Kissimmee, FL 34741-3501 | 2020-04-28 |
| 1124649561 | Scarlet Benilde Gonzalez | Family Medicine | 4319 Creeks Run Blvd, Kissimmee, FL 34746-2314 | 2020-04-27 |
| 1952872061 | Olga Lorena Seoanes | Family Medicine | 2068 E Osceola Pkwy, Kissimmee, FL 34743-8602 | 2018-12-16 |
| 1457822066 | Surujdai Pooransingh | Family Medicine | 354 Aylesbury Ct, Kissimmee, FL 34758-4298 | 2018-12-07 |
| 1174011571 | Summit Health Family Practice LLC | Family Medicine | 507 Berry James Ct, Kissimmee, FL 34744-8514 | 2018-05-01 |
| 1932613882 | Mi Doctor LLC | Family Medicine | 4611 Cumbrian Lakes Dr, Kissimmee, FL 34746-6717 | 2017-11-29 |
| 1013360395 | Derly Jean-noel | Family Medicine | 3380 Wilderness Trl, Kissimmee, FL 34746-2926 | 2016-07-21 |
| Find all providers in KISSIMMEE | ||||
Please comment or provide details below to improve the information on FAMILY TREE MEDICAL GROUP, PA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.