Unknown Individual – Physician Assistant, NPI 1659340123

Unknown Individual is a healthcare provider. based in Lehigh acres, Florida. specializing in Physician Assistant. They hold a License No. PA9103119 (FL). The NPI Number for Unknown Individual is 1659340123

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1659340123
Phone
(239) 274-8005
Address
2718 LEE BLVD
Deactivation Date
12 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2393039298
Graduation Year
1979 (47 years ago)
PAC ID
0840257705
Group Practice PAC ID
1951472885
Professional Enrollment ID
I20041213000908
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

  • 2718, Lee Boulevard, Lehigh Acres, Fort Myers, Lee County, Florida, 33971, United States

    STE B

    LEHIGH ACRES, FL 339711537

    Phone: (239) 274-8005

    Fax: (239) 275-8005

    Type: Location

  • 2nd Street, Fort Myers, Lee County, Florida, 33916, United States

    FORT MYERS, FL 339054808

    Phone: (239) 850-7519

    Type: Mailing

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 33971)

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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: 1951472885View full group profile
NameSpecialtyState
Family Practice, DermatologyFL
-FL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1659340123 — the number used across U.S. healthcare to identify this provider.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Lehigh Acres, Florida as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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