Unknown Individual – Diagnostic Radiology Physician, NPI 1275572919

Unknown Individual is a healthcare provider. based in Orlando, Florida. specializing in Diagnostic Radiology Physician. They hold a License No. ME56269 (FL). The NPI Number for Unknown Individual is 1275572919

Main info

Organization
Inactive
45 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1275572919
Phone
(352) 274-9565
Address
11050 LAKE UNDERHILL RD # 865394
Deactivation Date
13 September 2021

Doctor Profile

Medical School Name
LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Secondary Phone
3183689751
Graduation Year
1981 (45 years ago)
PAC ID
2668450313
Group Practice PAC ID
3779559984
Professional Enrollment ID
I20180831000065
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Lake Underhill Road, Orlando, Orange County, Florida, 32807, United States

    ORLANDO, FL 328255016

    Phone: (352) 274-9565

    Fax: (352) 342-9038

    Type: Mailing

  • Southwest 17th Street, Ocala, Marion County, Florida, 34474, United States

    OCALA, FL 344711227

    Phone: (352) 274-9565

    Fax: (352) 342-9038

    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.

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.

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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 32825)

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Provider's Procedures

Unknown Individual performs procedures in Diagnostic Radiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DIAGNOSTIC RADIOLOGYFL73562X-ray of knee, 3 views1914

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: 3779559984View full group profile

Reviews

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Frequently asked questions

What is the standard ID for Unknown Individual in the U.S.?
In the U.S., Unknown Individual is identified by NPI 1275572919.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Orlando, Florida?
For routing, start with Orlando, Florida for Unknown Individual, then verify phone and hours locally.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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