Unknown Individual – Clinical Social Worker, NPI 1790846269

Unknown Individual is a healthcare provider. based in Coral springs, Florida. specializing in Clinical Social Worker. They hold a License No. SW 5769 (FL). The NPI Number for Unknown Individual is 1790846269

Main info

Organization
Inactive
33 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1790846269
Phone
(954) 345-5644
Address
11760 W SAMPLE RD
Deactivation Date
16 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9543455644
Graduation Year
1993 (33 years ago)
PAC ID
2769627397
Group Practice PAC ID
1951362870
Professional Enrollment ID
I20130401000490
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

  • West Sample Road, Coral Springs, Broward County, Florida, 33064, United States

    SUITE 101

    CORAL SPRINGS, FL 330653199

    Phone: (954) 345-5644

    Fax: (954) 345-5683

    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 33065)

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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: 1951362870View full group profile
NameSpecialtyState
Clinical Social WorkerFL
Clinical PsychologistFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Mental Health CounselorFL
Clinical Social WorkerFL

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 1790846269 for Unknown Individual.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Coral Springs, Florida?
If you are local to Coral Springs, Florida, Unknown Individual may be relevant to your search.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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