Unknown Individual – General Practice Physician, NPI 1386716850

Unknown Individual is a healthcare provider. based in Vero beach, Florida. specializing in General Practice Physician. They hold a License No. ME0048344 (FL). The NPI Number for Unknown Individual is 1386716850

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1386716850
Phone
(772) 567-4500
Address
631 17TH ST
Deactivation Date
9 December 2020

Doctor Profile

Medical School Name
UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
9638068455
Professional Enrollment ID
I20071016000316
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

  • 631, 17th Street, Riomar, Vero Beach, Indian River County, Florida, 32963, United States

    VERO BEACH, FL 329605518

    Phone: (772) 567-4500

    Fax: (772) 567-1714

    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 32960)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1386716850 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under General Practice Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Vero Beach, Florida in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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