Unknown Individual – Foot & Ankle Surgery Podiatrist, NPI 1679551535

Unknown Individual is a healthcare provider. based in Coral springs, Florida. specializing in Foot & Ankle Surgery Podiatrist. They hold a License No. P0629 (FL). The NPI Number for Unknown Individual is 1679551535

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1679551535
Phone
(954) 753-3030
Address
817 CORAL RIDGE DR
Deactivation Date
9 May 2022

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
9547533030
Graduation Year
1971 (55 years ago)
PAC ID
4082639943
Group Practice PAC ID
7214080282
Professional Enrollment ID
I20070505000054
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

  • Coral Ridge Drive, Coral Springs, Broward County, Florida, 33071, United States

    CORAL SPRINGS, FL 330714180

    Phone: (954) 753-3030

    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 33071)

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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: 7214080282View full group profile
NameSpecialtyState
-FL
P O D I A T R YFL
P O D I A T R YFL
P O D I A T R YMI
P O D I A T R YFL
P O D I A T R YOH
P O D I A T R YFL
-FL
P O D I A T R YFL
P O D I A T R YFL

Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1679551535.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Foot & Ankle Surgery Podiatrist. Clinical services aligned with this taxonomy classification.
Where in Florida is Unknown Individual registered?
Use Coral Springs, Florida as the headline location for Unknown Individual here.
Can I trust this NPI listing for Unknown Individual?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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