Unknown Individual – Family Medicine Physician, NPI 1124082987

Unknown Individual is a healthcare provider. based in Davie, Florida. specializing in Family Medicine Physician. They hold a License No. OS0003372 (FL). The NPI Number for Unknown Individual is 1124082987

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124082987
Phone
(954) 791-7101
Address
5930 SW 64TH AVE
Deactivation Date
2 December 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

Loading map...

Provider Addresses for Unknown Individual

  • Davie Road, Downtown Davie, Playland Village, Davie, Broward County, Florida, 33314, United States

    DAVIE, FL 333147116

    Phone: (954) 791-7101

    Fax: (954) 791-2521

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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 33314)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1124082987 as the unique 10-digit identifier.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Davie?
Unknown Individual currently maps to Davie, Florida in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

Similar Providers

Unknown Individual

Family Medicine Physician
2150, Southwest 113th Avenue, Davie, Broward County, Florida, 33325, United States
NPI: 1174520126

DR. ARMANDO JR. ROCA (D.O.)

Family Medicine Physician
1801, Southwest 117th Avenue, Davie, Broward County, Florida, 33325, United States
NPI: 1073511754

DR. PATRICIA L. BIERUT-DAREN (D.O.)

Family Medicine Physician
4780 SW 64TH AVE STE 103
NPI: 1447257175

AMY L SEINFELD (DO)

Family Medicine Physician
350, Northwest 84th Avenue, Plantation, Broward County, Florida, 33324, United States
NPI: 1942281142

LEV TAYTS (DO)

Family Medicine Physician
3050, White Plains Road, The Bronx, Bronx County, New York, 10467, United States
NPI: 1760469142

Unknown Individual

Family Medicine Physician
South University Drive, Davie, Broward County, Florida, 33324, United States
NPI: 1083691042
Davie Road, Downtown Davie, Playland Village, Davie, Broward County, Florida, 33314, United States
NPI: 1720066822

DEAN BARRY ADELMAN (DO)

Family Medicine Physician
260 AVENUE X
NPI: 1962465518

DR. GLENN KEITH MORAN (DO,FACOFP)

Family Medicine Physician
3201, Southwest 135th Terrace, Davie, Broward County, Florida, 33330, United States
NPI: 1801850672