Unknown Individual – Diagnostic Radiology Physician, NPI 1265404040

Unknown Individual is a healthcare provider. based in Pensacola, Florida. specializing in Diagnostic Radiology Physician. They hold a License No. 14612 (NC). The NPI Number for Unknown Individual is 1265404040

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1265404040
Phone
(850) 456-9587
Address
33 LAKESIDE DR
Deactivation Date
29 November 2021
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:0State licenses:3Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 33 LAKESIDE DR

    PENSACOLA, FL 325073407

    Phone: (850) 456-9587

    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 32507)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1265404040 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Pensacola, Florida as the reference point for Unknown Individual, then confirm.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.