Unknown Individual – Family Medicine Physician, NPI 1174520126

Unknown Individual is a healthcare provider. based in Davie, Florida. specializing in Family Medicine Physician. They hold a License No. ME0026299 (FL). The NPI Number for Unknown Individual is 1174520126

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1174520126
Phone
(954) 961-8394
Address
2150 SW 113TH AVE
Deactivation Date
13 January 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

  • 2150, Southwest 113th Avenue, Davie, Broward County, Florida, 33325, United States

    DAVIE, FL 333254865

    Phone: (954) 961-8394

    Fax: (954) 241-0445

    Type: Mailing

  • 6301, Pembroke Road, Hollywood, Broward County, Florida, 33023, United States

    HOLLYWOOD, FL 330232217

    Phone: (954) 961-8394

    Fax: (954) 241-0445

    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 $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2023-04-28 • Largest payer in this snapshot: Mylan Specialty L.P. ($27).

Total Amount

$27

General + Research + Ownership

Payments

1

Total payment records

General Amount

$27

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Mylan Specialty L.P.$27
View all Open Payments →|Open Payments Risk Radar →

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 33325)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1174520126.
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.
Which community is linked to Unknown Individual?
Unknown Individual shows a connection to Davie, Florida in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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