Unknown Individual – Obstetrics & Gynecology Physician, NPI 1407805336
Obstetrics & Gynecology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
356 SW Miracle Ct
Lake City, FL 320240562
Phone: (386) 365-3845
Type: Location
19344 Cumberland Way
Detroit, MI 482031456
Phone: (386) 365-3845
Type: Location
840, Lobo Canyon Road, Grants, Cibola County, New Mexico, 87020, United States
GRANTS, NM 870202172
Phone: (386) 386-3845
Fax: (505) 393-1076
Type: Location
Grants Post Office, Copper Avenue, Grants, Cibola County, New Mexico, 87020, United States
GRANTS, NM 870207191
Phone: (386) 365-3845
Fax: (505) 393-1076
Type: Mailing
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 32024)
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.