Healthcare Provider Details

I. General information

NPI: 1619363785
Provider Name (Legal Business Name): DR. ELISE KRAMER, O.D. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 NE 203RD ST SUITE 116
MIAMI FL
33180-1900
US

IV. Provider business mailing address

19390 COLLINS AVE APT 1222
SUNNY ISLES BEACH FL
33160-2200
US

V. Phone/Fax

Practice location:
  • Phone: 305-814-2299
  • Fax: 514-316-6609
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPC4805
License Number StateFL

VIII. Authorized Official

Name: ELISE KRAMER
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 305-814-2299