Unknown Individual – Cardiovascular Disease Physician, NPI 1710980834

Cardiovascular Disease Physician

Unknown Individual is a healthcare provider. based in Jacksonville, Florida. specializing in Cardiovascular Disease Physician. They hold a License No. ME36641 (FL). The NPI Number for Unknown Individual is 1710980834

Main info

Organization

Inactive

49 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1710980834

Phone

(904) 388-1820

Address

1824 KING ST

Deactivation Date

20 February 2025

Doctor Profile

Medical School Name

UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE

Secondary Phone

9043881820

Graduation Year

1977 (49 years ago)

PAC ID

9638181100

Group Practice PAC ID

2860411188

Professional Enrollment ID

I20090505000521

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

King Street, Riverside, Jacksonville, Duval County, Florida, 32204, United States of America
SUITE 300
JACKSONVILLE, FL 322044736
Phone: (904) 388-1820
Fax: (904) 388-1827
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 32204)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.

Specialty	Practice State	HCPCS Code	Description	Service Count	Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)	FL	78452	Nuclear medicine study of vessels of heart using drugs or exercise multiple studies	181	180
CARDIOVASCULAR DISEASE (CARDIOLOGY)	FL	93010	Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report	294	229

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: 2860411188View full group profile

Name	Specialty	State
KATHRYN ELIZABETH MELKO (PHD, RD, CDE)	-	FL
RYAN N PAFFORD (MS, MSPAS, PA-C)	Physician Assistant	FL
CARLOS MORA	-	FL
DR. MARTHA B WOMACK (PHD)	-	FL
MELANIE LEHMANN (ARNP)	-	FL
DR. FELIPE VELAZQUEZ (DO)	Family Practice	FL
Unknown Individual	-	FL
MRS. SYLVIA PATRICIA RATLIFF (NP-C)	-	FL
Unknown Individual	-	FL
BARBARA LEIGH CRUIKSHANK (MD)	Family Practice	FL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1710980834?

NPI 1710980834 belongs to Unknown Individual; compare other details if you need extra assurance.

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 Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.

Is Unknown Individual associated with Jacksonville?

Public fields place Unknown Individual around Jacksonville, Florida. Always confirm the exact site before visiting.

What does 2 location(s) imply?

2 practice locations appear in the available data.

NPI: 1164425377

DR. MARIANO B MIKULIC (MD)

King Street, Riverside, Jacksonville, Duval County, Florida, 32204, United States of America

NPI: 1639172836

DR. BRETT MATTHEW SASSEEN (MD)

Interventional Cardiology Physician

7011 A C Skinner Pkwy

NPI: 1194728360

DR. STEVEN S NAUMAN (MD)