Individual provider Active NPI

Fabiola Rocho Margara, MATY1

  • Health Service Clinic/Center
  • Fort Walton Beach, FL
National Provider Identifier
1154011641
Registry record updated May 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
49710993 Issued in NY
Practice address
446 Racetrack Rd NW Unit C
Fort Walton Beach, FL 32547-1544
Phone
(850) 226-9012
NPI assigned
May 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory TechnicianGroup: 193200000X MULTI-SPECIALTY GROUP 246RM2200X 49710993 NY
Health Service Clinic/Center 261QH0100X 49710993 NY Primary

Addresses

Primary practice location

446 Racetrack Rd NW Unit C
Fort Walton Beach, FL 32547-1544

Mailing address

451 Shrewsbury Rd
Mary Esther, FL 32569-1735
Phone (850) 226-9012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
49710993NYMDMedical Laboratory Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683936000000",
    "number": "1154011641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 SHREWSBURY RD",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691735",
            "telephone_number": "850-226-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 RACETRACK RD NW UNIT C",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471544",
            "telephone_number": "850-226-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHO MARGARA",
        "first_name": "FABIOLA",
        "credential": "MATY1",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "NY",
            "license": "49710993",
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NY",
            "license": "49710993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.