Healthcare Provider Details

I. General information

NPI: 1770402489
Provider Name (Legal Business Name): MAKARIOS SAMIR DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 SAINT JOHNS AVE
PALATKA FL
32177-4649
US

IV. Provider business mailing address

906 NOBLE RUN
NEW SMYRNA BEACH FL
32168-2494
US

V. Phone/Fax

Practice location:
  • Phone: 386-328-2710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH16031
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: