Unknown Individual – Internal Medicine Physician, NPI 1306139845

Internal Medicine Physician

Unknown Individual is a healthcare provider. based in Jacksonville, Florida. specializing in Internal Medicine Physician. They hold a License No. ME 121002 (FL). The NPI Number for Unknown Individual is 1306139845

Main info

Organization

Inactive

16 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1306139845

Phone

(718) 715-2293

Address

4131 UNIVERSITY CENTER BLVD

Deactivation Date

28 September 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

5618426141

Graduation Year

2010 (16 years ago)

PAC ID

3577886316

Group Practice PAC ID

7719203041

Professional Enrollment ID

I20141230002427

Data current as of

20 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

4131 UNIVERSITY CENTER BLVD
SUITE 8
JACKSONVILLE, FL 32216
Phone: (718) 715-2293
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 32216)

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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: 7719203041View full group profile

Name	Specialty	State
DR. BENJAMIN JACOB PAZIN (M.D.)	-	FL
BANDULA WIJEWARDENA (ARNP)	-	FL
SAMANTHA SHROUDER (M.D.)	-	FL
MYRLANDE PIERRE	-	FL
MR. YU SONG (M.D)	-	FL
EMEM UDO (MD)	-	GA
CHRISTIAN NOEL A CESA (M.D.)	-	FL
MRS. PATRICIA JUBRECZKI (ARNP)	-	FL
DR. VENKAT KALIDINDI	-	FL
MICHAEL COREY ZAPLIN (MD)	-	FL

Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?

The registry entry for Unknown Individual shows NPI 1306139845.

What does inactive NPI status mean for Unknown Individual?

Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.

What services align with Unknown Individual's listing?

Unknown Individual's public classification highlights Internal Medicine Physician. Clinical services aligned with this taxonomy classification.

Is Unknown Individual tied to Jacksonville, Florida?

If you are local to Jacksonville, Florida, Unknown Individual may be relevant to your search.

What is the difference between NPI and a medical license?

An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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