Unknown Individual – Radiation Oncology Physician, NPI 1467434654

Unknown Individual is a healthcare provider. based in Lake city, Florida. specializing in Radiation Oncology Physician. They hold a License No. ME110540 (FL). The NPI Number for Unknown Individual is 1467434654

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1467434654
Phone
(352) 755-0601
Address
4520 W US HIGHWAY 90
Deactivation Date
18 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4782722255
Graduation Year
1982 (44 years ago)
PAC ID
0042236697
Group Practice PAC ID
1153677505
Professional Enrollment ID
I20110531000651
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • West US Highway 90, San Antonio, Bexar County, Texas, 78227, United States

    LAKE CITY, FL 320558341

    Phone: (352) 755-0601

    Fax: (352) 755-0602

    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 32055)

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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 1467434654.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
What kind of provider is Unknown Individual?
The page reflects Radiation Oncology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Lake City, 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.