Unknown Individual – Internal Medicine Physician, NPI 1558330662

Unknown Individual is a healthcare provider. based in Orange city, Florida. specializing in Internal Medicine Physician. They hold a License No. ME71092 (FL). The NPI Number for Unknown Individual is 1558330662

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1558330662
Phone
(386) 668-9800
Address
747 FAWN RIDGE DR STE 200
Deactivation Date
19 April 2023
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

Provider Addresses for Unknown Individual

  • 747 FAWN RIDGE DR STE 200

    ORANGE CITY, FL 327638268

    Phone: (386) 668-9800

    Fax: (386) 668-3777

    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.

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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 32763)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1558330662 — the number used across U.S. healthcare to identify this provider.
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 Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Orange City?
Unknown Individual currently maps to Orange City, Florida in this extract.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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