Unknown Individual – Emergency Medicine Physician, NPI 1710037916

Unknown Individual is a healthcare provider. based in Tampa, Florida. specializing in Emergency Medicine Physician. They hold a License No. 0029931 (FL). The NPI Number for Unknown Individual is 1710037916

Main info

Organization
Inactive
62 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710037916
Phone
(727) 644-5983
Address
4804 LONGWATER WAY
Deactivation Date
11 January 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8637772740
Graduation Year
1964 (62 years ago)
PAC ID
0749186583
Group Practice PAC ID
8921317942
Professional Enrollment ID
I20070605000510
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

  • 4804 LONGWATER WAY

    TAMPA, FL 336154216

    Phone: (727) 644-5983

    Type: Mailing

  • HCA Florida - West Tampa Hospital, 6001, Webb Road, Penner, Tampa, Hillsborough County, Florida, 33615, United States

    TAMPA, FL 33615

    Phone: (813) 882-7130

    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 33615)

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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: 8921317942View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1710037916 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Tampa, Florida as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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