Unknown Individual – Clinical Social Worker, NPI 1366404915

Unknown Individual is a healthcare provider. based in Brandon, Florida. specializing in Clinical Social Worker. They hold a License No. SW6353 (FL). The NPI Number for Unknown Individual is 1366404915

Main info

Organization
Inactive
30 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1366404915
Phone
(813) 956-6189
Address
605 W Bloomingdale Ave
Deactivation Date
28 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7276982543
Graduation Year
1996 (30 years ago)
PAC ID
0042357436
Professional Enrollment ID
I20091015000697
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

Provider Addresses for Unknown Individual

  • 605 W Bloomingdale Ave

    Brandon, FL 335117444

    Phone: (813) 956-6189

    Type: Location

  • 6177, Sun Boulevard, Isla Del Sol, Saint Petersburg, Pinellas County, Florida, 33715, United States

    #404

    ST PETERSBURG, FL 33715

    Phone: (727) 698-2543

    Type: Mailing

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 33511)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1366404915.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Brandon, Florida for Unknown Individual; download NPPES for the complete set.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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