Unknown Individual – Pediatrics Physician, NPI 1053391417

Unknown Individual is a healthcare provider. based in Miami, Florida. specializing in Pediatrics Physician. They hold a License No. ME 11500 (FL). The NPI Number for Unknown Individual is 1053391417

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053391417
Phone
(305) 553-4341
Address
2597 SW 87TH AVE
Deactivation Date
17 February 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2597, Southwest 87th Avenue, Hialeah, Miami-Dade County, Florida, 33165, United States

    MIAMI, FL 331652082

    Phone: (305) 553-4341

    Fax: (305) 553-2336

    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 33165)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1053391417 — is the standard way to identify this listing.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Miami, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.