Unknown Individual – Psychiatry Physician, NPI 1467448357

Unknown Individual is a healthcare provider. based in Bartow, Florida. specializing in Psychiatry Physician. They hold a License No. ME28653 (FL). The NPI Number for Unknown Individual is 1467448357

Main info

Organization
Inactive
67 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1467448357
Phone
(863) 519-0575
Address
PO BOX 1559
Deactivation Date
1 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8634992520
Graduation Year
1959 (67 years ago)
PAC ID
7810184827
Group Practice PAC ID
7719877927
Professional Enrollment ID
I20101202001111
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

  • Bartow Post Office, East Summerlin Street, Bartow, Polk County, Florida, 33830, United States

    BARTOW, FL 338311559

    Phone: (863) 519-0575

    Fax: (863) 534-7028

    Type: Mailing

  • 1255, Golfview Avenue, Bartow, Polk County, Florida, 33830, United States

    BARTOW, FL 338306736

    Phone: (863) 519-3750

    Fax: (863) 534-7028

    Type: Location

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 33831)

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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: 7719877927View full group profile
NameSpecialtyState
P S Y C H I A T R YFL
Clinical Social WorkerFL
P S Y C H I A T R YFL
Mental Health CounselorFL
Clinical Social WorkerFL
Clinical Social WorkerFL
-FL
Marriage And Family TherapistFL
Clinical Social WorkerFL
-FL

Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1467448357 if you need a stable reference for Unknown Individual.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Psychiatry Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Bartow, Florida because that is what the record indicates for Unknown Individual.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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