Unknown Individual – Cardiovascular Disease Physician, NPI 1568438661

Unknown Individual is a healthcare provider. based in Gainesville, Florida. specializing in Cardiovascular Disease Physician. They hold a License No. ME33054 (FL). The NPI Number for Unknown Individual is 1568438661

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1568438661
Phone
(352) 264-2500
Address
4645 NW 8TH AVE
Deactivation Date
30 November 2021

Doctor Profile

Medical School Name
PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
Secondary Phone
3523318570
Graduation Year
1970 (56 years ago)
PAC ID
7315917184
Group Practice PAC ID
8820077241
Professional Enrollment ID
I20070831000035
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4645, Northwest 8th Avenue, City of Gainesville Municipal Boundaries, Alachua County, Florida, 32605, United States

    GAINESVILLE, FL 326054524

    Phone: (352) 264-2500

    Fax: (352) 331-9095

    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 32605)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report246220
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93284Evaluation, testing and programming adjustment of defibrillator with analysis, review and report5550

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: 8820077241View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)FL
Interventional Cardiology, Cardiovascular Disease (Cardiology)NC
Nurse PractitionerFL
Cardiovascular Disease (Cardiology), Interventional CardiologyFL
Cardiovascular Disease (Cardiology), Interventional CardiologyFL
Nurse PractitionerIN
Interventional Cardiology, Cardiovascular Disease (Cardiology)FL
Interventional Cardiology, Cardiovascular Disease (Cardiology)PA
Physician AssistantFL
Interventional Cardiology, Cardiovascular Disease (Cardiology)FL

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1568438661 — is the standard way to identify this listing.
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 is Unknown Individual's specialty?
The listing groups Unknown Individual with Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Gainesville, Florida in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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