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General NPI Number Information
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NPI Number | 1942744206
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Entity Type | Individual
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Provider Name | LUIS RAUL POMALES RPH
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Gender | Male
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Dates
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Enumeration Date | 12/06/2016
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Last Update Date | 12/06/2016
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Provider Practice Location Address
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Address Line | 19326 MAJESTIC ST
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City | ORLANDO
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State | FL
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Zip | 32833-3048
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Country | US
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Telephone | 407-443-2751
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Fax | 321-804-5042
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Provider Business Mailing Address
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Address Line | 19326 MAJESTIC ST
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City | ORLANDO
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State | FL
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Zip | 32833-3048
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Country | US
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Telephone | 407-443-2751
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Fax | 321-804-5042
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2510
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22325
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP-032854-R
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License Number State | PA
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