Unknown Individual – Family Nurse Practitioner, NPI 1821053083

Unknown Individual is a healthcare provider. based in Brooksville, Florida. specializing in Family Nurse Practitioner. They hold a License No. ARNP 2156622 (FL). The NPI Number for Unknown Individual is 1821053083

Main info

Organization
Inactive
21 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1821053083
Phone
(352) 610-9905
Address
12220 CORTEZ BLVD
Deactivation Date
28 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3526831982
Graduation Year
2005 (21 years ago)
PAC ID
9830107242
Group Practice PAC ID
5496752347
Professional Enrollment ID
I20060327000718
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

  • Cortez Boulevard, Brooksville, Hernando County, Florida, United States

    BROOKSVILLE, FL 346132631

    Phone: (352) 610-9905

    Fax: (352) 610-9907

    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 34613)

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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: 5496752347View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Emergency MedicineLA
Family PracticeFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1821053083 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Family Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Brooksville, Florida may find Unknown Individual in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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