Unknown Individual – Internal Medicine Physician, NPI 1790842201

Unknown Individual is a healthcare provider. based in Navarre, Florida. specializing in Internal Medicine Physician. They hold a License No. ME69924 (FL). The NPI Number for Unknown Individual is 1790842201

Main info

Organization
Inactive
31 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790842201
Phone
(850) 936-9665
Address
7552 NAVARRE PKWY
Deactivation Date
19 June 2025

Doctor Profile

Medical School Name
EASTERN VIRGINIA MEDICAL SCHOOL
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
1850295163
Professional Enrollment ID
I20051214000023
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

  • Navarre Parkway, Navarre, Santa Rosa County, Florida, 32566, United States

    UNIT 45

    NAVARRE, FL 325667305

    Phone: (850) 936-9665

    Fax: (850) 936-4476

    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 32566)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1790842201 is assigned to Unknown Individual under the national enumeration system.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Florida?
You will see Navarre, Florida on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1790842201. Always confirm identity and privileges with the practice and licensing boards.

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