Unknown Individual – Specialist, NPI 1255345963

Unknown Individual is a healthcare provider. based in Fort lauderdale, Florida. specializing in Specialist. They hold a License No. ME0048892 (FL). The NPI Number for Unknown Individual is 1255345963

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1255345963
Phone
(954) 524-2250
Address
315 SE 14TH ST
Deactivation Date
13 February 2025

Doctor Profile

Medical School Name
NEW YORK MEDICAL COLLEGE
Secondary Phone
9545242250
Graduation Year
1979 (47 years ago)
PAC ID
0547230575
Group Practice PAC ID
4789654757
Professional Enrollment ID
I20100706000066
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 315, Southeast 14th Street, Fort Lauderdale, Broward County, Florida, 33316, United States

    FORT LAUDERDALE, FL 333161929

    Phone: (954) 524-2250

    Fax: (954) 524-5833

    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)

CMS reports 3 Open Payments records for all available years, with a total value of $2,097.

Total Amount is formed as General ($125) + Research ($1,972) + Ownership ($0) = $2,097.

Last reported payment date: 2023-11-15 • Largest payer in this snapshot: Theratechnologies Inc. ($1,972).

Total Amount

$2,097

General + Research + Ownership

Payments

3

Total payment records

General Amount

$125

General payments

Research Amount

$1,972

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-15

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes1111$0
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Insurance plans in this area (ZIP 33316)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1255345963 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Other Service Providers for Unknown Individual. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Fort Lauderdale, Florida in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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