Unknown Individual – Emergency Medicine Physician, NPI 1083667224

Unknown Individual is a healthcare provider. based in Port st lucie, Florida. specializing in Emergency Medicine Physician. They hold a License No. ME15307 (FL). The NPI Number for Unknown Individual is 1083667224

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083667224
Phone
(772) 398-3800
Address
1800 SE TIFFANY AVE
Deactivation Date
25 January 2023
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

  • Saint Lucie Medical Center, 1800, Southeast Tiffany Avenue, Port St. Lucie, St. Lucie County, Florida, 34952, United States

    PORT ST LUCIE, FL 349527521

    Phone: (772) 398-3800

    Type: Location

  • 15, Park Avenue, Vero Beach, Indian River County, Florida, 32960, United States

    VERO BEACH, FL 329605228

    Phone:

    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.

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Medicare Enrollment & Revalidation

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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 34952)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1083667224 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Port St Lucie, Florida for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1083667224. Always confirm identity and privileges with the practice and licensing boards.

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