Provider Demographics
NPI:1013570597
Name:POMARES CASTILLO, REYNIER (MD)
Entity Type:Individual
Prefix:
First Name:REYNIER
Middle Name:
Last Name:POMARES CASTILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 NW 173RD DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5114
Mailing Address - Country:US
Mailing Address - Phone:305-556-7500
Mailing Address - Fax:305-851-5708
Practice Address - Street 1:5961 NW 173RD DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5114
Practice Address - Country:US
Practice Address - Phone:305-556-7500
Practice Address - Fax:305-851-5708
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-19
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME158245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine