Unknown Individual – Internal Medicine Physician, NPI 1023012978

Unknown Individual is a healthcare provider. based in Fort myers, Florida. specializing in Internal Medicine Physician. They hold a License No. OS10071 (FL). The NPI Number for Unknown Individual is 1023012978

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023012978
Phone
(877) 856-3774
Address
2675 WINKLER AVE FL 2
Deactivation Date
29 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2395618033
Graduation Year
1996 (30 years ago)
PAC ID
8123113826
Group Practice PAC ID
9830244433
Professional Enrollment ID
I20071121000151
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • Winkler Avenue, Fort Myers, Lee County, Florida, 33966, United States

    FORT MYERS, FL 339019342

    Phone: (877) 856-3774

    Type: Mailing

  • 21297 OLEAN BLVD STE A

    PORT CHARLOTTE, FL 339526704

    Phone: (855) 979-5700

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes4822$0
View full utilization report →

Insurance plans in this area (ZIP 33901)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9830244433View full group profile
NameSpecialtyState
Family PracticeFL
Nurse PractitionerFL
Nurse PractitionerFL
Family PracticeFL
-FL
-FL
Internal MedicineFL
-FL
Family PracticeFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1023012978 if you need a stable reference for Unknown Individual.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Fort Myers, Florida for Unknown Individual; expand the address list for detail.
What if Fort Myers, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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