Unknown Individual – Internal Medicine Physician, NPI 1487620506

Unknown Individual is a healthcare provider. based in Ft walton beach, Florida. specializing in Internal Medicine Physician. They hold a License No. ME0062733 (FL). The NPI Number for Unknown Individual is 1487620506

Main info

Organization
Inactive
37 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1487620506
Phone
(850) 863-2118
Address
1025 BEAL PKWY NW
Deactivation Date
5 April 2022

Doctor Profile

Medical School Name
UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1989 (37 years ago)
PAC ID
7618008392
Professional Enrollment ID
I20100624000023
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

  • Beal Parkway Northwest, Fort Walton Beach, Okaloosa County, Florida, 32548, United States

    SUITE A

    FT WALTON BEACH, FL 325471446

    Phone: (850) 863-2118

    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.

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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.

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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 32547)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1487620506 when you need to reference Unknown Individual in forms, claims, or directories.
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 Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Ft Walton Beach, Florida for Unknown Individual; download NPPES for the complete set.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1487620506. Always confirm identity and privileges with the practice and licensing boards.

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