Unknown Individual – Physical Medicine & Rehabilitation Physician, NPI 1649202375

Unknown Individual is a healthcare provider. based in Winter haven, Florida. specializing in Physical Medicine & Rehabilitation Physician. They hold a License No. 036128196 (IL). The NPI Number for Unknown Individual is 1649202375

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1649202375
Phone
(863) 293-1121
Address
200 AVE F NE
Deactivation Date
10 September 2021

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
8135914570
Graduation Year
1997 (29 years ago)
PAC ID
2668489030
Group Practice PAC ID
3577821958
Professional Enrollment ID
I20181113001980
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:0State licenses:3Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Winter Haven Hospital, 200, Avenue F Northeast, Winter Haven, Polk County, Florida, 33881, United States

    WINTERHAVEN HOSPITAL

    WINTER HAVEN, FL 338814131

    Phone: (863) 293-1121

    Fax: (863) 297-1788

    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 33881)

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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: 3577821958View full group profile
NameSpecialtyState
Nurse PractitionerSC
Nurse PractitionerWA
Undersea And Hyperbaric Medicine, Family PracticeMO
P O D I A T R YNY
Nurse PractitionerFL
Pain ManagementSC
P O D I A T R YSC

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1649202375 — the number used across U.S. healthcare to identify this provider.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Physical Medicine & Rehabilitation Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Winter Haven, Florida as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.