Unknown Individual – Emergency Medicine Physician, NPI 1962481739
Excluded from federal healthcare programs (Medicare/Medicaid)
This provider is listed on the OIG List of Excluded Individuals/Entities (LEIE). Exclusion effective: 2011-09-20. Reason: License revocation, suspension, or surrender.
Emergency Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1855, Northeast 8th Street, Four Seasons Mobile Home Park, Homestead, Miami-Dade County, Florida, 33033, United States
CAMPBELL URGENT CARE
HOMESTEAD, FL 330334705
Phone: (305) 242-8025
Fax: (305) 245-1839
Type: Location
35, Venetian Way, Miami Beach, Miami-Dade County, Florida, 33139, United States
APT 103
MIAMI BEACH, FL 33139
Phone: (305) 531-1921
Fax: (305) 531-1921
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.
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 33033)
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