MEDICARE: DR. ALICE KAREN POMIDOR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	ME91581	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457462046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICE KAREN POMIDOR M.D.

Provider Business Mailing Address
First Line	:	1115 W CALL ST
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32306-4300
Country	:	US
Telephone Number	:	850-644-1543
Fax Number	:	850-645-0577

Provider Business Practice Location Address
First Line	:	4449 MEANDERING WAY
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-5740
Country	:	US
Telephone Number	:	850-645-1543
Fax Number	:	552-307-4028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	03/30/2026

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