Unknown Individual – Anesthesiologist Assistant, NPI 1700861325

Anesthesiologist Assistant

Unknown Individual is a healthcare provider. based in Sunrise, Florida. specializing in Anesthesiologist Assistant. They hold a License No. R103350 (MD). The NPI Number for Unknown Individual is 1700861325

Main info

Organization

Inactive

49 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1700861325

Phone

Not provided

Address

PO BOX 452395

Deactivation Date

19 August 2022

Doctor Profile

Medical School Name

OTHER

Secondary Phone

2027750574

Graduation Year

1977 (49 years ago)

PAC ID

2860465739

Group Practice PAC ID

1153597521

Professional Enrollment ID

I20050715000382

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

PO BOX 452395
SUNRISE, FL 333452395
Phone:
Type: Mailing
UM Medical Center Midtown Campus (UMMC), 827, Linden Avenue, Mount Vernon, Baltimore, Maryland, 21201, United States
BALTIMORE, MD 212014606
Phone: (410) 225-8000
Type: Location

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 33345)

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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: 1153597521View full group profile

Name	Specialty	State
JOHN A TAM (M.D.)	-	MD
ALEXANDER K EITEL (MD)	A N E S T H E S I O L O G Y	MD
STEVEN J. SALTZMAN (MD)	A N E S T H E S I O L O G Y	MD
NATHANIEL FULLER (M.D.)	A N E S T H E S I O L O G Y	MD
CLAIRE E. JENKINS (CRNA)	-	VA
DR. JAMAAL SNELL (M.D.)	A N E S T H E S I O L O G Y	NY
MS. KIMBERLY A. STRANDBERG (CRNA)	Certified Registered Nurse Anesthetist (Crna)	IL
MISS DANA LYNN HARRISON	Certified Registered Nurse Anesthetist (Crna)	MD
MRS. SARAH NAOMI BRESLER (CRNA)	Certified Registered Nurse Anesthetist (Crna)	DC
SETH KENNETH BRONY (C.R.N.A.)	-	MD