Healthcare Provider Details

I. General information

NPI: 1114487550
Provider Name (Legal Business Name): LEE HAKAMI KILMER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LEE MOR HAKAMI MD

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST FL 4
MIAMI FL
33136-2107
US

IV. Provider business mailing address

1120 NW 14TH ST FL 4
MIAMI FL
33136-2107
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-7500
  • Fax: 305-243-4535
Mailing address:
  • Phone: 305-243-7500
  • Fax: 305-243-4535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberME184020
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: