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NPI Code Detail

MEDICARE: VYACHESLAV MAKAROV DPM PA

MEDICARE: VYACHESLAV MAKAROV DPM PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristPO3522FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902167810
Entity Type Code : Organization
Provider Name (Legal Business Name) : VYACHESLAV MAKAROV DPM PA
Provider Business Mailing Address
First Line : 230 174TH ST
Second Line : 2214
City : SUNNY ISLES BEACH
State : FL
Zip : 33160-3332
Country : US
Telephone Number : 917-324-0919
Fax Number : 305-354-7111
Provider Business Practice Location Address
First Line : 1400 NE MIAMI GARDENS DR STE 105
Second Line :
City : NORTH MIAMI BEACH
State : FL
Zip : 33179-4843
Country : US
Telephone Number : 305-974-5933
Fax Number :
Authorized Official
Title or Position : DPM
Name : VYACHESLAV MAKAROV
Credential : DPM
Telephone Number : 917-324-0919
Provider Enumeration Date : 06/06/2012
Last Update Date : 04/09/2020

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