Provider Demographics
NPI:1124398417
Name:LOUIS M. MAKAROWSKI, PH.D., P.A.
Entity Type:Organization
Organization Name:LOUIS M. MAKAROWSKI, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:MAKAROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-477-7181
Mailing Address - Street 1:5120 BAYOU BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2193
Mailing Address - Country:US
Mailing Address - Phone:850-477-7181
Mailing Address - Fax:850-477-7197
Practice Address - Street 1:5120 BAYOU BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2193
Practice Address - Country:US
Practice Address - Phone:850-477-7181
Practice Address - Fax:850-477-7197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY2429103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74206AMedicare UPIN