Unknown Individual – Pediatric Occupational Therapist, NPI 1790040590

Pediatric Occupational Therapist

Unknown Individual is a healthcare provider. based in Cape coral, Florida. specializing in Pediatric Occupational Therapist. They hold a License No. OT 11676 (FL). The NPI Number for Unknown Individual is 1790040590

Main info

Organization

Inactive

Name

Unknown Individual

NPI

1790040590

Phone

(239) 297-6395

Address

2055 WILLOW BRANCH DR

Deactivation Date

19 July 2023

Data current as of

20 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

2055 WILLOW BRANCH DR
CAPE CORAL, FL 339913506
Phone: (239) 297-6395
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 33991)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?

Unknown Individual — NPI 1790040590 — is the standard way to identify this listing.

Why might Unknown Individual appear inactive while still practicing?

We display what the registry publishes: Unknown Individual appears inactive there.

What taxonomy line describes Unknown Individual?

For research purposes, treat Unknown Individual as Pediatric Occupational Therapist in this dataset. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual based?

Unknown Individual is tied to Cape Coral, Florida in the data we show; additional addresses may exist on the full record.

How many locations tie to this NPI?

2 practice locations appear in the available data.