Provider Demographics
NPI:1427009240
Name:MAKOWSKI, MICHAEL KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:KEVIN
Last Name:MAKOWSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:345 CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-3111
Mailing Address - Country:US
Mailing Address - Phone:386-672-4244
Mailing Address - Fax:386-672-0603
Practice Address - Street 1:345 CLYDE MORRIS BLVD
Practice Address - Street 2:SUITE 330
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-3111
Practice Address - Country:US
Practice Address - Phone:386-672-4244
Practice Address - Fax:386-672-0603
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0052230207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2150833OtherAETNA
FL18778423210OtherUNITED HEALTH CARE
FL078608000Medicaid
FL078608000Medicaid
FL2150833OtherAETNA