Unknown Individual – Addiction (Substance Use Disorder) Counselor, NPI 1053446823

Unknown Individual is a healthcare provider. based in St petersburg, Florida. specializing in Addiction (Substance Use Disorder) Counselor. They hold a License No. 2507 (FL). The NPI Number for Unknown Individual is 1053446823

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1053446823
Phone
(727) 502-0784
Address
4754 COBIA DR SE
Deactivation Date
28 April 2021
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

  • 4754 COBIA DR SE

    STE B

    ST PETERSBURG, FL 33705

    Phone: (727) 502-0784

    Type: Mailing

  • 6440 FIRST AVE NORTH

    ST PETERSBURG, FL 33710

    Phone: (727) 251-8189

    Fax: (727) 499-7575

    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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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No Medicare enrollment or revalidation data available for this provider in our database.

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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 33705)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1053446823 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Addiction (Substance Use Disorder) Counselor. Clinical services aligned with this taxonomy classification.
Where in Florida is Unknown Individual registered?
Use St Petersburg, Florida as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.