Unknown Individual – Physician Assistant, NPI 1669569067

Unknown Individual is a healthcare provider. based in Apollo beach, Florida. specializing in Physician Assistant. They hold a License No. PA3420 (FL). The NPI Number for Unknown Individual is 1669569067

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1669569067
Phone
(813) 810-3176
Address
5005 CLOVER MIST DR
Deactivation Date
12 December 2024
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

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Provider Addresses for Unknown Individual

  • 5005 CLOVER MIST DR

    APOLLO BEACH, FL 335723415

    Phone: (813) 810-3176

    Type: Mailing

  • South Bay Hospital, 4016, Sun City Center Boulevard, Sun City Center, Hillsborough County, Florida, 33573, United States

    SUN CITY CENTER, FL 335735256

    Phone: (813) 634-0136

    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 33572)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1669569067 — 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 Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Apollo Beach, Florida in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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