Unknown Individual – Retina Specialist (Ophthalmology) Physician, NPI 1790733020

Unknown Individual is a healthcare provider. based in Fort myers, Florida. specializing in Retina Specialist (Ophthalmology) Physician. The NPI Number for Unknown Individual is 1790733020

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790733020
Phone
(239) 939-4323
Address
6901 INTERNATIONAL CENTER BLVD
Deactivation Date
18 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience10
Completeness75
Years active:0State licenses:0Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 6901 INTERNATIONAL CENTER BLVD

    FORT MYERS, FL 339127125

    Phone: (239) 939-4323

    Fax: (239) 939-3983

    Type: Mailing

  • 2525, Harbor Boulevard, Port Charlotte, Charlotte County, Florida, 33952, United States

    SUITE 302

    PT CHARLOTTE, FL 339525317

    Phone: (239) 939-4323

    Fax: (239) 939-3983

    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 33912)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1790733020.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Retina Specialist (Ophthalmology) Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Fort Myers, Florida may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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