Unknown Individual – Physician Assistant, NPI 1154462554

Unknown Individual is a healthcare provider. based in Panama city beach, Florida. specializing in Physician Assistant. The NPI Number for Unknown Individual is 1154462554

Main info

Organization
Inactive
32 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1154462554
Phone
(850) 234-1898
Address
16900 FRONT BEACH RD
Deactivation Date
28 January 2022

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1994 (32 years ago)
PAC ID
7113162926
Professional Enrollment ID
I20130708000737
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience5
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 16900, Front Beach Road, Whisper Dunes, Gulf Resort Beach, Panama City Beach, Bay County, Florida, 32413, United States

    PANAMA CITY BEACH, FL 324132345

    Phone: (850) 234-1898

    Fax: (850) 234-7670

    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 32413)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1154462554.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Physician Assistant. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Panama City Beach, Florida?
If you are local to Panama City Beach, Florida, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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