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FAMILY TREE MEDICAL GROUP II, PA - Florida Company Profile

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Company Details

Entity Name: FAMILY TREE MEDICAL GROUP II, PA
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 25 Feb 2022 (4 years ago)
Document Number: P22000017259
FEI/EIN Number 88-1080158
Address: 2201 NORTH BLVD WEST, #2, DAVENPORT, FL, 33837, US
Mail Address: 2201 NORTH BLVD W, SUITE #2, DAVENPORT, FL, 33837, US
ZIP code: 33837
City: Davenport
County: Polk
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
PANTOJA VICTOR MJR. Chief Executive Officer 2201 NORTH BLVD WEST, DAVENPORT, FL, 33837
GONZALEZ FRANCELIS IMD President 2201 NORTH BLVD WEST, DAVENPORT, FL, 33837
PANTOJA VICTOR MJR. Agent 2201 NORTH BLVD WEST, DAVENPORT, FL, 33837

National Provider Identifier

NPI Number:
1720727654
Certification Date:
2022-12-14

Authorized Person:

Name:
MR. VICTOR M PANTOJA JR.
Role:
BUISNESS OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
8634199547

Documents

Name Date
ANNUAL REPORT 2025-01-30
ANNUAL REPORT 2024-02-04
ANNUAL REPORT 2023-02-22
Domestic Profit 2022-02-25

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Date of last update: 03 Aug 2025

Sources: Florida Department of State