Provider Demographics
NPI:1235985268
Name:KERI M POMELLA OD PA
Entity type:Organization
Organization Name:KERI M POMELLA OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POMELLA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:786-558-9043
Mailing Address - Street 1:1001 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4103
Mailing Address - Country:US
Mailing Address - Phone:786-953-5480
Mailing Address - Fax:786-762-2926
Practice Address - Street 1:1001 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4103
Practice Address - Country:US
Practice Address - Phone:785-953-5480
Practice Address - Fax:786-762-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty