Unknown Individual – Internal Medicine Physician, NPI 1003809716

Internal Medicine Physician

Unknown Individual is a healthcare provider. based in Doral, Florida. specializing in Internal Medicine Physician. They hold a License No. ME120392 (FL). The NPI Number for Unknown Individual is 1003809716

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1003809716

Phone

Not provided

Address

11551 LAKESIDE DR

Deactivation Date

22 November 2023

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience23

Completeness75

Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

11551 LAKESIDE DR
#7401
DORAL, FL 331783022
Phone:
Type: Mailing
100 NW 170th St
STE 410
North Miami Beach, FL 331695513
Phone: (305) 585-6969
Type: Location
11551 LAKESIDE DR APT 7401
DORAL, FL 331783022
Phone: (301) 490-4526
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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33178)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?

Use NPI 1003809716 when you need to reference Unknown Individual in forms, claims, or directories.

Is Unknown Individual's inactive status permanent?

An inactive NPI does not by itself prove someone stopped practicing — check other sources.

What does Unknown Individual treat or focus on?

Patients typically see Unknown Individual under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.

Does Unknown Individual practice in Florida?

You will see Doral, Florida on file for Unknown Individual alongside any extra practice locations.

What if Doral, Florida seems incomplete?

Street-level detail can be omitted — open the full address list for this NPI.