Individual provider Active NPI

Rachel Escobio Roche, OD

  • Optometrist
  • Lakeland, FL
National Provider Identifier
1700522406
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC6139 Issued in FL
Practice address
1251 Lakeland Hills Blvd
Lakeland, FL 33805-4673
Phone
(863) 687-2260
NPI assigned
May 6, 2022
Last updated
Jul 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Optometrist 152W00000X OPC6139 FL Primary

Addresses

Primary practice location

1251 Lakeland Hills Blvd
Lakeland, FL 33805-4673

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • Rachel Escobio Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220713002015 FL Practitioner - Optometry 7517348295 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC6139FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Florida, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jul 11, 2022 Accepting new patients
Myeyedr Optometry of Florida, LLC Optometrist CurrentSince Jul 11, 2022 Accepting new patients

Locations

1251 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 687-2260

4337 S Florida Ave
Lakeland, FL 33813
Phone (863) 619-2700

1480 Timberlane Rd
Tallahassee, FL 32312
Phone (850) 878-1601

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 3

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": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1700522406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054673",
            "telephone_number": "863-687-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBIO ROCHE",
        "first_name": "RACHEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC6139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "ESCOBIO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.