Unknown Individual – Pain Medicine (Anesthesiology) Physician, NPI 1164482311

Pain Medicine (Anesthesiology) Physician

Unknown Individual is a healthcare provider. based in Lakeland, Florida. specializing in Pain Medicine (Anesthesiology) Physician. They hold a License No. ME24608 (FL). The NPI Number for Unknown Individual is 1164482311

Main info

Organization

Inactive

65 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1164482311

Phone

(863) 862-7246

Address

202 PARKVIEW PL

Deactivation Date

29 April 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8636827246

Graduation Year

1961 (65 years ago)

PAC ID

4880656628

Group Practice PAC ID

4880756204

Professional Enrollment ID

I20041103000256

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

202, Parkview Place, Lakeland, Polk County, Florida, 33805, United States
LAKELAND, FL 338054548
Phone: (863) 862-7246
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.

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.

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

Insurance plans in this area (ZIP 33805)

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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: 4880756204View full group profile

Name	Specialty	State
DR. SAQIB B KHAN (M.D.)	Interventional Pain Management	GA
CARLOS ALBERTO BOTERO (M.D.)	Pain Management, Anesthesiology	FL

Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?

You can confirm Unknown Individual with NPI 1164482311; it appears in the national provider directory.

Is Unknown Individual's inactive status permanent?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

Can you summarize Unknown Individual's specialty in plain language?

Clinically, the directory lists Unknown Individual with Pain Medicine (Anesthesiology) Physician. Clinical services aligned with this taxonomy classification.

What location shows for Unknown Individual?

We surface Lakeland, Florida for Unknown Individual based on available NPPES addresses.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.