Unknown Individual – Clinical Psychologist, NPI 1184647075

Unknown Individual is a healthcare provider. based in Tamarac, Florida. specializing in Clinical Psychologist. They hold a License No. PY 0004549 (FL). The NPI Number for Unknown Individual is 1184647075

Main info

Organization
Inactive
36 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1184647075
Phone
(954) 454-5500
Address
7455 FAIRFAX DR BLDG F
Deactivation Date
10 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1990 (36 years ago)
PAC ID
1951434927
Professional Enrollment ID
I20100728000924
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

  • 7455 FAIRFAX DR BLDG F

    TAMARAC, FL 333214336

    Phone: (954) 454-5500

    Fax: (954) 926-0170

    Type: Mailing

  • 2855 N UNIVERSITY DR STE 200

    CORAL SPRINGS, FL 330651403

    Phone: (954) 454-5500

    Fax: (954) 926-0170

    Type: Location

  • 1250 E Hallandale Beach Blvd

    Suite 1006

    Hallandale Beach, FL 330094634

    Phone: (954) 454-5500

    Fax: (954) 926-0170

    Type: Location

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.

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Medicare Enrollment & Revalidation

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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 33321)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1184647075 — the number used across U.S. healthcare to identify this provider.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual associated with Tamarac?
Public fields place Unknown Individual around Tamarac, Florida. Always confirm the exact site before visiting.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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