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KIDSVILLE PEDIATRICS V, P.A.

Company Details

Entity Name: KIDSVILLE PEDIATRICS V, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 27 Aug 2009 (15 years ago)
Document Number: P09000072482
FEI/EIN Number 270811936
Address: 1050 W CARROLL ST, KISSIMMEE, FL, 34741
Mail Address: P.O. BOX 452223, KISSIMMEE, FL, 34745
ZIP code: 34741
County: Osceola
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1215265343 2009-12-01 2019-08-13 1050 W CARROLL ST, KISSIMMEE, FL, 347411268, US 1050 W CARROLL ST, KISSIMMEE, FL, 347411268, US

Contacts

Phone +1 407-518-0078
Fax 4075180094

Authorized person

Name DR. FRANCELIS I. GONZALEZ
Role MEDICAL DOCTOR
Phone 4075180078

Taxonomy

Taxonomy Code 208000000X - Pediatrics Physician
License Number ME0074421
State FL
Is Primary Yes

Agent

Name Role Address
PANTOJA VICTOR MJr. Agent 1050 W CARROLL ST, KISSIMMEE, FL, 34741

Chief Executive Officer

Name Role Address
GONZALEZ FRANCELIS I Chief Executive Officer PO BOX 452223, KISSIMMEE, FL, 34745

President

Name Role Address
PANTOJA VICTOR MJr. President P.O. BOX 452223, KISSIMMEE, FL, 34745

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2013-03-03 PANTOJA, VICTOR M., Jr. No data
CHANGE OF MAILING ADDRESS 2010-03-22 1050 W CARROLL ST, KISSIMMEE, FL 34741 No data

Documents

Name Date
ANNUAL REPORT 2024-02-04
ANNUAL REPORT 2023-02-17
ANNUAL REPORT 2022-02-22
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-02-17
ANNUAL REPORT 2019-02-09
ANNUAL REPORT 2018-03-10
ANNUAL REPORT 2017-02-10
ANNUAL REPORT 2016-03-04
ANNUAL REPORT 2015-02-21

Date of last update: 01 Feb 2025

Sources: Florida Department of State