Unknown Individual – Interventional Cardiology Physician, NPI 1346243136

Unknown Individual is a healthcare provider. based in Leesburg, Florida. specializing in Interventional Cardiology Physician. They hold a License No. ME77804 (FL). The NPI Number for Unknown Individual is 1346243136

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1346243136
Phone
(352) 728-6808
Address
511 MEDICAL PLAZA DR
Deactivation Date
9 August 2021

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
3527505000
Graduation Year
1997 (29 years ago)
PAC ID
9537109616
Group Practice PAC ID
6507839735
Professional Enrollment ID
I20101118001274
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

  • Medical Plaza Drive, Leesburg, Lake County, Florida, 32748, United States

    SUITE 101

    LEESBURG, FL 347487326

    Phone: (352) 728-6808

    Fax: (352) 728-1743

    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 34748)

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Provider's Procedures

Unknown Individual performs procedures in Interventional Cardiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL85610Blood test, clotting time1354260
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL92928Catheter insertion of stents in major coronary artery or branch, accessed through the skin5245
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report14791
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93284Evaluation, testing and programming adjustment of defibrillator with analysis, review and report2619
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93458Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart4948

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: 6507839735View 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 1346243136.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Interventional Cardiology Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Leesburg, Florida. Check all listed addresses for suites or satellite offices.
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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