Healthcare Provider Details

I. General information

NPI: 1841401593
Provider Name (Legal Business Name): FERNANDO POMERANIEC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 NE 191ST ST STE 702A
AVENTURA FL
33180-2834
US

IV. Provider business mailing address

2875 NE 191ST ST STE 702A
AVENTURA FL
33180-2834
US

V. Phone/Fax

Practice location:
  • Phone: 305-785-5268
  • Fax: 305-675-3362
Mailing address:
  • Phone: 305-785-5268
  • Fax: 305-675-3362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME100822
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME100822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: