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	OPC3040	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	:	1639547201
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KERI M POMELLA, OD PA

Provider Business Mailing Address
First Line	:	1550 W 84TH ST STE 15
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-3368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 W 84TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33014-3377
Country	:	US
Telephone Number	:	786-558-9043
Fax Number	:	786-762-2926

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	KERI MARIE POMELLA
Credential	:
Telephone Number	:	786-558-9043

Provider Enumeration Date	:	09/12/2015
Last Update Date	:	12/09/2025

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