Unknown Individual – Medical Physician Assistant, NPI 1861486789

Unknown Individual is a healthcare provider. based in Macdill afb, Florida. specializing in Medical Physician Assistant. They hold a License No. PA9102370 (FL). The NPI Number for Unknown Individual is 1861486789

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1861486789
Phone
(813) 827-9871
Address
USSOCOM CLINIC
Deactivation Date
16 November 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience18
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • USSOCOM CLINIC

    3250 ZEMKE AVE

    MACDILL AFB, FL 33621

    Phone: (813) 827-9871

    Fax: (813) 828-4436

    Type: Location

  • 15th Street North, Saint Petersburg, Pinellas County, Florida, 33702, United States

    SAINT PETERSBURG, FL 337022946

    Phone: (813) 545-6736

    Type: Mailing

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.

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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 33621)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1861486789.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Medical Physician Assistant in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Macdill Afb, Florida. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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