Unknown Individual – Family Medicine Physician, NPI 1073508057

Unknown Individual is a healthcare provider. based in Miramar, Florida. specializing in Family Medicine Physician. They hold a License No. OS5734 (FL). The NPI Number for Unknown Individual is 1073508057

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1073508057
Phone
(954) 276-5685
Address
2900 CORPORATE WAY
Deactivation Date
3 March 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

  • Corporate Way, Miramar, Broward County, Florida, 33025, United States

    DOOR D

    MIRAMAR, FL 330253925

    Phone: (954) 276-5685

    Fax: (954) 985-7074

    Type: Mailing

  • 17786, Southwest 2nd Street, Pembroke Pines, Broward County, Florida, 33029, United States

    PEMBROKE PINES, FL 330293923

    Phone: (954) 265-8100

    Fax: (954) 436-6875

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2023-05-11 • Largest payer in this snapshot: Bayer Healthcare Pharmaceuticals Inc. ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-11

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 33025)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1073508057.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Family Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Miramar, Florida.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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