Unknown Individual – Optometrist, NPI 1063408110

Unknown Individual is a healthcare provider. based in Palm beach gardens, Florida. specializing in Optometrist. They hold a License No. FL1014 (FL). The NPI Number for Unknown Individual is 1063408110

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063408110
Phone
(561) 842-2020
Address
2560 RCA BLVD
Deactivation Date
24 August 2021
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

  • 2560, RCA Boulevard, Monet, North Palm Beach, Palm Beach Gardens, Palm Beach County, Florida, 33410, United States

    SUITE 114

    PALM BEACH GARDENS, FL 334103338

    Phone: (561) 842-2020

    Fax: (561) 622-4636

    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 33410)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1063408110 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Optometrist in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Palm Beach Gardens, Florida in our summary view.
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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