Unknown Individual – Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, NPI 1770821811

Unknown Individual is a healthcare provider. based in Lake city, Florida. specializing in Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist. They hold a License No. RPT22570 (FL). The NPI Number for Unknown Individual is 1770821811

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1770821811
Phone
(352) 339-2560
Address
1147 SE GRAHAM CT
Deactivation Date
6 July 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1147 SE GRAHAM CT

    LAKE CITY, FL 320252841

    Phone: (352) 339-2560

    Type: Mailing

  • 3135 1st Ave N

    13214

    St Petersburg, FL 337339461

    Phone: (352) 339-2560

    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.

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 32025)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1770821811.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Lake City, Florida in our summary view.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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