Unknown Individual – Physical Therapist, NPI 1720184344

Unknown Individual is a healthcare provider. based in Daytona beach, Florida. specializing in Physical Therapist. They hold a License No. PT2714 (FL). The NPI Number for Unknown Individual is 1720184344

Main info

Organization
Inactive
47 Years Of Experience
Name
Unknown Individual
NPI
1720184344
Phone
(386) 257-2672
Address
100 PROFESSIONAL BLVD
Deactivation Date
3 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3862572672
Graduation Year
1979 (47 years ago)
PAC ID
7810155660
Group Practice PAC ID
0941285068
Professional Enrollment ID
I20120224000124
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

  • 100, Professional Boulevard, Daytona Beach, Volusia County, Florida, 32114, United States

    DAYTONA BEACH, FL 32114

    Phone: (386) 257-2672

    Fax: (386) 252-1005

    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 32114)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYFL97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes97274
PHYSICAL THERAPYFL97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes103379

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: 0941285068View full group profile
NameSpecialtyState
-FL

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1720184344?
NPI 1720184344 belongs to Unknown Individual; compare other details if you need extra assurance.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Physical Therapist. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Daytona Beach?
Unknown Individual currently maps to Daytona Beach, Florida in this extract.
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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