Unknown Individual – Neurological Surgery Physician, NPI 1063409258

Unknown Individual is a healthcare provider. based in Fort lauderdale, Florida. specializing in Neurological Surgery Physician. They hold a License No. 10679 (FL). The NPI Number for Unknown Individual is 1063409258

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063409258
Phone
(954) 771-4215
Address
1930 NE 47TH ST
Deactivation Date
13 November 2020
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

  • 1930, Northeast 47th Street, Coral Hills, Fort Lauderdale, Broward County, Florida, 33308, United States

    SUITE 200

    FORT LAUDERDALE, FL 333087718

    Phone: (954) 771-4215

    Fax: (954) 491-4892

    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.

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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 33308)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1063409258?
NPI 1063409258 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Neurological Surgery Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Fort Lauderdale, Florida.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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