Unknown Individual – Cardiovascular Disease Physician, NPI 1275636805

Unknown Individual is a healthcare provider. based in Jacksonville, Florida. specializing in Cardiovascular Disease Physician. They hold a License No. ME18615 (FL). The NPI Number for Unknown Individual is 1275636805

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1275636805
Phone
(904) 224-5189
Address
PO BOX 43667
Deactivation Date
6 January 2022
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

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Provider Addresses for Unknown Individual

  • Box Tree Court, Arbor Pointe, Jacksonville, Duval County, Florida, 32225, United States

    JACKSONVILLE, FL 322033667

    Phone: (904) 224-5189

    Fax: (904) 725-1622

    Type: Mailing

  • 1348, South 18th Street, Fernandina Beach, Nassau County, Florida, 32034, United States

    BLDG B, SUITE 200

    FERNANDINA BEACH, FL 320344785

    Phone: (904) 261-9786

    Fax: (904) 277-4143

    Type: Location

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.

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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 32203)

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Provider's Procedures

Unknown Individual performs procedures in Cardiovascular Disease Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL78452Nuclear medicine study of vessels of heart using drugs or exercise multiple studies196196
CARDIOVASCULAR DISEASE (CARDIOLOGY)FL93280Evaluation, testing, and programming adjustment of permanent dual lead pacemaker system with physician analysis, review, and report2218

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1275636805 on file in the registry.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Jacksonville, Florida as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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