MEDICARE: KERI M POMELLA, OD PA

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1144041435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KERI M POMELLA, OD PA

Provider Business Mailing Address
First Line	:	1833 NE MIAMI GARDENS DR
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33179-5035
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 NE MIAMI GARDENS DR
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-5035
Country	:	US
Telephone Number	:	305-932-5601
Fax Number	:	786-762-2926

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KERI MARIE POMELLA
Credential	:	OD
Telephone Number	:	305-932-5601

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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