Unknown Individual – Otolaryngology Physician, NPI 1114014776

Unknown Individual is a healthcare provider. based in Coral springs, Florida. specializing in Otolaryngology Physician. They hold a License No. 34071 (FL). The NPI Number for Unknown Individual is 1114014776

Main info

Organization
Inactive
60 Years Of Experience
Name
Unknown Individual
NPI
1114014776
Phone
(954) 753-8010
Address
3000 UNIVERSITY DRIVE
Deactivation Date
24 May 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1966 (60 years ago)
PAC ID
8729239355
Professional Enrollment ID
I20121126000046
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

  • 3000, North University Drive, Coral Springs, Broward County, Florida, 33065, United States

    SUITE G

    CORAL SPRINGS, FL 33065

    Phone: (954) 753-8010

    Fax: (954) 753-9964

    Mailing address matches the actual address.

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 33065)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1114014776 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Coral Springs, Florida for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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