Provider Demographics
NPI:1366965857
Name:MAKKI, FAWAZ MOHAMMEDMAKKI HASSAN (MD)
Entity type:Individual
Prefix:DR
First Name:FAWAZ
Middle Name:MOHAMMEDMAKKI HASSAN
Last Name:MAKKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:FAWAZ
Other - Middle Name:MOHAMMED MAKKI
Other - Last Name:MAKKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:661 E ALTAMONTE DR STE 325
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5103
Mailing Address - Country:US
Mailing Address - Phone:407-303-4120
Mailing Address - Fax:407-303-4124
Practice Address - Street 1:410 CELEBRATION PL STE 305
Practice Address - Street 2:
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5436
Practice Address - Country:US
Practice Address - Phone:407-303-4120
Practice Address - Fax:407-303-4124
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME133287207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology