Unknown Individual – Ophthalmology Physician, NPI 1063414688

Unknown Individual is a healthcare provider. based in Tampa, Florida. specializing in Ophthalmology Physician. They hold a License No. ME0007546 (FL). The NPI Number for Unknown Individual is 1063414688

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063414688
Phone
(813) 877-2020
Address
3000 W DR MARTIN LUTHER KING JR BLVD
Deactivation Date
12 June 2025
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

  • 3000, West Dr. Martin Luther King Jr Boulevard, Tampa, Hillsborough County, Florida, 33607, United States

    TAMPA, FL 336076308

    Phone: (813) 877-2020

    Fax: (813) 872-7387

    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)

CMS reports 2 Open Payments records for all available years, with a total value of $3,017.

Total Amount is formed as General ($3,017) + Research ($0) + Ownership ($0) = $3,017.

Last reported payment date: 2024-11-18 • Largest payer in this snapshot: Skeletal Dynamics Inc ($3,000).

Total Amount

$3,017

General + Research + Ownership

Payments

2

Total payment records

General Amount

$3,017

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-18

Latest reported date

Top Companies

Largest payers in this snapshot

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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 33607)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1063414688.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Ophthalmology Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Tampa, Florida?
If you are local to Tampa, Florida, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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