Unknown Individual – Adult Health Nurse Practitioner, NPI 1356683916

Unknown Individual is a healthcare provider. based in Temple terrace, Florida. specializing in Adult Health Nurse Practitioner. They hold a License No. ARNP9279639 (FL). The NPI Number for Unknown Individual is 1356683916

Main info

Organization
Inactive
14 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356683916
Phone
(813) 871-8200
Address
12470 TELECOM DR
Deactivation Date
21 November 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8136852440
Graduation Year
2012 (14 years ago)
PAC ID
8123265923
Group Practice PAC ID
2769465210
Professional Enrollment ID
I20130515000551
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

  • 12470 TELECOM DR

    SUITE 300 WEST

    TEMPLE TERRACE, FL 336370904

    Phone: (813) 871-8200

    Fax: (813) 871-8199

    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)

CMS reports 8 Open Payments records for all available years, with a total value of $179.

Total Amount is formed as General ($179) + Research ($0) + Ownership ($0) = $179.

Last reported payment date: 2023-11-20 • Largest payer in this snapshot: Progenics Pharmaceuticals, Inc. ($62).

Total Amount

$179

General + Research + Ownership

Payments

8

Total payment records

General Amount

$179

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-11-20

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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 33637)

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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: 2769465210View full group profile
NameSpecialtyState
Radiation OncologyFL
Radiation OncologyFL
Radiation OncologyFL
Radiation Oncology, Internal Medicine, Medical OncologyFL
U R O L O G YFL

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1356683916 if you need a stable reference for Unknown Individual.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Adult Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Temple Terrace, Florida for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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