Unknown Individual – Sports Medicine (Neuromusculoskeletal Medicine) Physician, NPI 1962565721

Unknown Individual is a healthcare provider. based in Miami, Florida. specializing in Sports Medicine (Neuromusculoskeletal Medicine) Physician. They hold a License No. ME41633 (FL). The NPI Number for Unknown Individual is 1962565721

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1962565721
Phone
(305) 585-6262
Address
1611 NW 12TH AVE
Deactivation Date
9 December 2020
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Jackson Memorial Hospital, 1611, Northwest 12th Avenue, Miami, Miami-Dade County, Florida, 33136, United States

    MIAMI, FL 331361005

    Phone: (305) 585-6262

    Fax: (305) 585-2457

    Type: Location

  • 630, Solano Prado, Gables Estates, Coral Gables, Miami-Dade County, Florida, 33156, United States

    CORAL GABLES, FL 331562360

    Phone: (305) 661-9531

    Fax: (786) 268-7409

    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)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33136)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1962565721.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Sports Medicine (Neuromusculoskeletal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Miami, Florida?
If you are local to Miami, Florida, Unknown Individual may be relevant to your search.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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