Unknown Individual – Optometrist, NPI 1750353165

Unknown Individual is a healthcare provider. based in Miami lakes, Florida. specializing in Optometrist. They hold a License No. FL2609 (FL). The NPI Number for Unknown Individual is 1750353165

Main info

Organization
Inactive
34 Years Of Experience
Name
Unknown Individual
NPI
1750353165
Phone
(305) 821-0304
Address
15332 N.W. 79 COURT
Deactivation Date
21 March 2022

Doctor Profile

Medical School Name
NEW ENGLAND COLLEGE OF OPTOMETRY
Secondary Phone
-
Graduation Year
1992 (34 years ago)
PAC ID
9739333295
Professional Enrollment ID
I20130222000169
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

Provider Addresses for Unknown Individual

  • 15332 N.W. 79 COURT

    MIAMI LAKES, FL 33189

    Phone: (305) 821-0304

    Fax: (305) 558-0641

    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.

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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 33189)

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Provider's Procedures

Unknown Individual performs procedures in Optometrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
OPTOMETRYFL92083Measurement of field of vision during daylight conditions1716

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1750353165 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Optometrist in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Miami Lakes?
Unknown Individual currently maps to Miami Lakes, Florida in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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