Provider Demographics
NPI:1972681393
Name:ETKIN-KRAMER, ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:ETKIN-KRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 880
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-674-8038
Mailing Address - Fax:305-674-8192
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 880
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-674-8038
Practice Address - Fax:305-674-8192
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61877174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL373394700Medicaid
FL373394700Medicaid
FL18940TMedicare ID - Type Unspecified