Unknown Individual – Gerontology Nurse Practitioner, NPI 1063527935

Unknown Individual is a healthcare provider. based in Tampa, Florida. specializing in Gerontology Nurse Practitioner. They hold a License No. ARNP450122 (FL). The NPI Number for Unknown Individual is 1063527935

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1063527935
Phone
(813) 903-3611
Address
13000 BRUCE B DOWNS BLVD
Deactivation Date
18 June 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

  • James A. Haley Veterans' Hospital, 13000, Bruce B Downs Boulevard, Tampa, Hillsborough County, Florida, 33612, United States

    TAMPA, FL 336124745

    Phone: (813) 903-3611

    Fax: (813) 903-3637

    Type: Location

  • Four Lakes at Clearwater, 6550, 150th Avenue North, Highpoint, Clearwater, Pinellas County, Florida, 33760, United States

    CLEARWATER, FL 337602130

    Phone: (727) 433-3490

    Fax: (727) 535-7351

    Type: Mailing

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 33612)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1063527935.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
Does Unknown Individual list a primary specialty?
If you are matching referrals, note Gerontology Nurse Practitioner for Unknown Individual. Clinical services aligned with this taxonomy classification.
Where does public data place Unknown Individual?
The snapshot lists Tampa, Florida for Unknown Individual; download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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