Unknown Individual – Psychologist, NPI 1053363960

Unknown Individual is a healthcare provider. based in Daytona beach, Florida. specializing in Psychologist. They hold a License No. PY2214 (FL). The NPI Number for Unknown Individual is 1053363960

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053363960
Phone
(386) 235-2531
Address
403 N WILD OLIVE AVE
Deactivation Date
17 July 2024
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

  • 403, North Wild Olive Avenue, Daytona Beach, Volusia County, Florida, 32118, United States

    DAYTONA BEACH, FL 321183937

    Phone: (386) 235-2531

    Fax: (386) 253-6144

    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 32118)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1053363960.
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 Psychologist for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Florida?
You will see Daytona Beach, Florida on file for Unknown Individual alongside any extra practice locations.
What if Daytona Beach, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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