Unknown Individual – Family Medicine Physician, NPI 1174734958

Family Medicine Physician

Unknown Individual is a healthcare provider. based in Ruskin, Florida. specializing in Family Medicine Physician. They hold a License No. ME31419 (FL). The NPI Number for Unknown Individual is 1174734958

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1174734958

Phone

(813) 645-9009

Address

1611 EAST SHELL POINT ROAD

Deactivation Date

10 April 2024

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness75

Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

1611, East Shell Point Road, Ruskin, Hillsborough County, Florida, 33570, United States
RUSKIN, FL 33570
Phone: (813) 645-9009
Fax: (813) 902-6436
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 33570)

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

What is the 10-digit NPI for Unknown Individual?

Unknown Individual — NPI 1174734958 — is the standard way to identify this listing.

Is Unknown Individual's NPI deactivated?

The extract indicates Unknown Individual is not in an active NPI state.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Family Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.

Where should I expect Unknown Individual on a map?

Expect Ruskin, Florida as a primary anchor for Unknown Individual unless the record lists multiple sites.

Why does Unknown Individual have multiple addresses?

2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.