Unknown Individual – Family Medicine Physician, NPI 1083691042

Unknown Individual is a healthcare provider. based in Davie, Florida. specializing in Family Medicine Physician. They hold a License No. OS 3754 (FL). The NPI Number for Unknown Individual is 1083691042

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083691042
Phone
(954) 434-7246
Address
4691 S UNIVERSITY DR
Deactivation Date
7 July 2022
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

  • South University Drive, Davie, Broward County, Florida, 33324, United States

    DAVIE, FL 333283817

    Phone: (954) 434-7246

    Fax: (954) 434-8104

    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.

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 33328)

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Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1083691042 uniquely identifies Unknown Individual in U.S. healthcare data.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Davie, Florida?
For routing, start with Davie, Florida for Unknown Individual, then verify phone and hours locally.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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