Unknown Individual – Internal Medicine Physician, NPI 1780677401

Unknown Individual is a healthcare provider. based in Port charlotte, Florida. specializing in Internal Medicine Physician. They hold a License No. ME77553 (FL). The NPI Number for Unknown Individual is 1780677401

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1780677401
Phone
(941) 629-7777
Address
PO BOX 495659
Deactivation Date
1 May 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1986 (40 years ago)
PAC ID
0244261410
Professional Enrollment ID
I20050830000067
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

  • Box Street, Port Charlotte, Charlotte County, Florida, 33948, United States

    PORT CHARLOTTE, FL 339495659

    Phone: (941) 629-7777

    Fax: (941) 629-8170

    Type: Mailing

  • 2525, Harbor Boulevard, Port Charlotte, Charlotte County, Florida, 33952, United States

    308

    PORT CHARLOTTE, FL 339525317

    Phone: (941) 629-7777

    Fax: (941) 629-8170

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes847302$0
99213Established patient office or other outpatient visit, 20-29 minutes634217$0
36415Insertion of needle into vein for collection of blood sample291172$0
99215Established patient office or other outpatient visit, 40-54 minutes10680$0
99212Established patient office or other outpatient visit, 10-19 minutes9473$0
View full utilization report →

Insurance plans in this area (ZIP 33949)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEFL83036Hemoglobin A1C level189118

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1780677401 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
How should patients interpret Unknown Individual's specialty?
The extract shows Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Port Charlotte, Florida in registry-derived data.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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