Healthcare Provider Details

I. General information

NPI: 1861904849
Provider Name (Legal Business Name): ELIZABETH MAKAR PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 PRIMERA BLVD STE 1031
LAKE MARY FL
32746-2190
US

IV. Provider business mailing address

775 PRIMERA BLVD STE 1031
LAKE MARY FL
32746-2190
US

V. Phone/Fax

Practice location:
  • Phone: 407-603-1633
  • Fax: 321-204-7073
Mailing address:
  • Phone: 407-603-1633
  • Fax: 321-204-7073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS51095
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: