Unknown Individual – Family Medicine Physician, NPI 1275523383

Unknown Individual is a healthcare provider. based in Maitland, Florida. specializing in Family Medicine Physician. They hold a License No. ME72530 (FL). The NPI Number for Unknown Individual is 1275523383

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275523383
Phone
(407) 660-7011
Address
800 N MAITLAND AVE STE 203
Deactivation Date
20 March 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4073817364
Graduation Year
1981 (45 years ago)
PAC ID
9739224841
Group Practice PAC ID
0244135093
Professional Enrollment ID
I20100301000437
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

  • 800 N MAITLAND AVE STE 203

    MAITLAND, FL 327514499

    Phone: (407) 660-7011

    Fax: (407) 875-9002

    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 32751)

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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: 0244135093View full group profile

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1275523383 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Maitland, Florida.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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