Unknown Individual – Internal Medicine Physician, NPI 1871590349
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
128 CLEARLAKE DR
PONTE VEDRA BEACH, FL 320822109
Phone: (904) 905-3188
Type: Mailing
4800, Deerwood Campus Parkway, Florida Blue Offices, Jacksonville, Duval County, Florida, 32246, United States
DCC 3-4
JACKSONVILLE, FL 322466498
Phone: (904) 905-3188
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $37.
Total Amount is formed as General ($37) + Research ($0) + Ownership ($0) = $37.
Last reported payment date: 2023-07-20 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($21).
Total Amount
$37
General + Research + Ownership
Payments
2
Total payment records
General Amount
$37
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boehringer Ingelheim Pharmaceuticals, Inc. | $21 |
| PFIZER INC. | $16 |
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 32082)
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Reviews
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