Provider Demographics
NPI:1679823454
Name:KRAMER, ELISE GABRIELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:ELISE
Middle Name:GABRIELLE
Last Name:KRAMER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 NE 203RD ST
Mailing Address - Street 2:#116
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1900
Mailing Address - Country:US
Mailing Address - Phone:305-814-2299
Mailing Address - Fax:514-316-6609
Practice Address - Street 1:2627 NE 203RD ST
Practice Address - Street 2:#116
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1900
Practice Address - Country:US
Practice Address - Phone:305-814-2299
Practice Address - Fax:514-316-6609
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4805152W00000X
ZZ321217152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist