Unknown Individual – Clinical Social Worker, NPI 1073537890

Unknown Individual is a healthcare provider. based in Boynton beach, Florida. specializing in Clinical Social Worker. They hold a License No. SW4553 (FL). The NPI Number for Unknown Individual is 1073537890

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073537890
Phone
(561) 752-9490
Address
10301 HAGEN RANCH RD STE B6
Deactivation Date
5 June 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8888526672
Graduation Year
1984 (42 years ago)
PAC ID
7618934217
Group Practice PAC ID
6204733413
Professional Enrollment ID
I20041216000268
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

  • 10301 HAGEN RANCH RD STE B6

    BOYNTON BEACH, FL 334373723

    Phone: (561) 752-9490

    Fax: (561) 752-9491

    Type: Location

  • 409, Northeast 125th Street, North Miami, Miami-Dade County, Florida, 33161, United States

    NORTH MIAMI, FL 331615834

    Phone: (888) 852-6672

    Fax: (305) 891-4228

    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 33437)

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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: 6204733413View full group profile

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1073537890 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where in Florida is Unknown Individual registered?
Use Boynton Beach, Florida as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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