1619363785 NPI number — DR. ELISE KRAMER, O.D. LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619363785 NPI number — DR. ELISE KRAMER, O.D. LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. ELISE KRAMER, O.D. LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619363785
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19390 COLLINS AVE
Provider Second Line Business Mailing Address:
APT 1222
Provider Business Mailing Address City Name:
SUNNY ISLES BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33160-2200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2627 NE 203RD ST
Provider Second Line Business Practice Location Address:
SUITE 116
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-814-2299
Provider Business Practice Location Address Fax Number:
514-316-6609
Provider Enumeration Date:
04/15/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KRAMER
Authorized Official First Name:
ELISE
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
305-814-2299

Provider Taxonomy Codes

  • Taxonomy code: 152WC0802X , with the licence number:  OPC4805 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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