Unknown Individual – Ophthalmology Physician, NPI 1023081759

Unknown Individual is a healthcare provider. based in Daytona beach, Florida. specializing in Ophthalmology Physician. They hold a License No. ME14662 (FL). The NPI Number for Unknown Individual is 1023081759

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1023081759
Phone
(386) 255-5050
Address
505 HEALTH BLVD
Deactivation Date
6 December 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1968 (58 years ago)
PAC ID
1759438625
Professional Enrollment ID
I20090409000672
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

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Provider Addresses for Unknown Individual

  • 505, Health Boulevard, Daytona Beach, Volusia County, Florida, 32114, United States

    DAYTONA BEACH, FL 321141493

    Phone: (386) 255-5050

    Fax: (386) 255-5029

    Type: Location

  • 1700, Country Club Road, Eustis, Lake County, Florida, 32726, United States

    EUSTIS, FL 327265818

    Phone: (352) 357-3851

    Type: Mailing

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.

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32114)

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Provider's Procedures

Unknown Individual performs procedures in Ophthalmology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPHTHALMOLOGYFL92083Measurement of field of vision during daylight conditions1412

Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1023081759 is assigned to Unknown Individual under the national enumeration system.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What kind of provider is Unknown Individual?
The page reflects Ophthalmology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Daytona Beach, Florida because that is what the record indicates for Unknown Individual.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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