Active NPI
Mariya Fatakhova, PHARMD
- Pharmacist
- Plantation, FL
National Provider Identifier
1255066221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS61652
- Practice address
- 4100 S Hospital Dr Ste 101
Plantation, FL 33317-2831 - Phone
- (954) 583-4100
- Fax
- (954) 583-6767
- NPI assigned
- Jul 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS61652 | FL | Primary |
Addresses
Primary practice location
4100 S Hospital Dr Ste 101
Plantation, FL 33317-2831
Mailing address
4100 S Hospital Dr Ste 101
Plantation, FL 33317-2831
Phone (954) 583-4100
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS61652 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dee-Car Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1255066221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 S HOSPITAL DR STE 101",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333172831",
"telephone_number": "954-583-4100",
"fax_number": "954-583-6767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 S HOSPITAL DR STE 101",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333172831",
"telephone_number": "954-583-4100",
"fax_number": "954-583-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATAKHOVA",
"first_name": "MARIYA",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-22",
"last_updated": "2022-07-22",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS61652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.