Individual
MS. ELISE A MILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
502 S FREMONT AVE, APT #123, TAMPA, FL 33606-2068
(702) 308-3569
Mailing address
502 S FREMONT AVE, APT #123, TAMPA, FL 33606-2068
(702) 308-3569
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1625DT
KY
152W00000X
Optometrist
544
NV
152W00000X
Optometrist
OD 2576
TN
152W00000X
Optometrist
Primary
OPC 3924
FL
152W00000X
Optometrist
OPT13430T
CA
Other
Enumeration date
12/05/2006
Last updated
05/17/2010
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