Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1356349880

Endocrinology, Diabetes & Metabolism Physician

Unknown Individual is a healthcare provider. based in Winter haven, Florida. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. ME-86513 (FL). The NPI Number for Unknown Individual is 1356349880

Main info

Organization

Inactive

32 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1356349880

Phone

(863) 293-1191

Address

500 E CENTRAL AVE

Deactivation Date

15 March 2023

Doctor Profile

Medical School Name

GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

8632931191

Graduation Year

1994 (32 years ago)

PAC ID

2062457393

Group Practice PAC ID

1355240722

Professional Enrollment ID

I20050627000815

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

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Provider Addresses for Unknown Individual

500, East Central Avenue, Winter Haven, Polk County, Florida, 33880, United States
WINTER HAVEN, FL 338803053
Phone: (863) 293-1191
Fax: (863) 293-3635
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 33880)

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Provider's Procedures

Unknown Individual performs procedures in Endocrinology, Diabetes & Metabolism Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
ENDOCRINOLOGY	FL	83036	Hemoglobin A1C level	727	375

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: 1355240722View full group profile

Name	Specialty	State
DR. LOGAN FREDRIK HANSON (D.O)	Orthopedic Surgery	FL
ROBERT KEVIN LERNER (M.D.)	-	FL
EVA J SALAMON (M.D.)	-	FL
DR. OSAMA A HLALAH (M.D.)	-	FL
VICKI C MOORE-MORBY (APRN)	Nurse Practitioner	FL
JESSICA R HUGHES (ARNP)	-	FL
MARIA BELEN RIVERA-BONILLA (MD)	-	FL
JARED JACOBS (APRN)	Nurse Practitioner	FL
LINDA G WIDNER (ARNP)	-	FL
BOBBIE M SKUKOWSKI (ARNP)	-	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 1356349880.

Does inactive mean outdated data for Unknown Individual?

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

What does the directory say Unknown Individual does?

Insurance directories may phrase it differently, but here Unknown Individual maps to Endocrinology, Diabetes & Metabolism Physician. Clinical services aligned with this taxonomy classification.

What geographic area is tied to Unknown Individual?

Unknown Individual is associated with Winter Haven, Florida in the same public data insurers reference.

Why is information missing for Unknown Individual?

Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.