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General NPI Number Information
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NPI Number | 1073999785
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Entity Type | Individual
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Provider Name | ELLIOTT STEPHEN BRAFMAN O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 08/04/2015
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Provider Practice Location Address
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Address Line | 900 NW 17TH ST
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City | MIAMI
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State | FL
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Zip | 33136-1119
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Country | US
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Telephone | 305-439-3101
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Fax |
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Provider Business Mailing Address
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Address Line | 400 SW 1ST AVE APT 303
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-3477
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Country | US
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Telephone | 305-439-3101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 5104
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License Number State | FL
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