Unknown Individual – Psychiatry Physician, NPI 1215007240

Unknown Individual is a healthcare provider. based in Hialeah, Florida. specializing in Psychiatry Physician. They hold a License No. ME 33775 (FL). The NPI Number for Unknown Individual is 1215007240

Main info

Organization
Inactive
59 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1215007240
Phone
(305) 825-0300
Address
4175 W 20TH AVE
Deactivation Date
4 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3054243120
Graduation Year
1967 (59 years ago)
PAC ID
1355349770
Group Practice PAC ID
9931177334
Professional Enrollment ID
I20160301001080
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

  • Citrus Health Network, 4175, West 20th Avenue, Hialeah, Miami-Dade County, Florida, 33012, United States

    HIALEAH, FL 330125874

    Phone: (305) 825-0300

    Fax: (305) 424-3180

    Type: Location

  • 6820, Southwest 94th Avenue, Sunset, Miami, Miami-Dade County, Florida, 33173, United States

    MIAMI, FL 331732232

    Phone: (305) 542-7756

    Fax: (305) 595-7671

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $59.

Total Amount is formed as General ($59) + Research ($0) + Ownership ($0) = $59.

Last reported payment date: 2023-08-09 • Largest payer in this snapshot: ABBVIE INC. ($26).

Total Amount

$59

General + Research + Ownership

Payments

3

Total payment records

General Amount

$59

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-08-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 33012)

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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: 9931177334View full group profile
NameSpecialtyState
Nurse PractitionerFL
P S Y C H I A T R YFL
Psychiatry, General PracticeFL
-FL
Nurse PractitionerFL
-FL
P S Y C H I A T R YTX
Emergency MedicineFL
P S Y C H I A T R YFL
P S Y C H I A T R YMI

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1215007240 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Florida?
You will see Hialeah, Florida on file for Unknown Individual alongside any extra practice locations.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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