Provider Demographics
NPI:1093728230
Name:POU, CELIO F (MD)
Entity Type:Individual
Prefix:DR
First Name:CELIO
Middle Name:F
Last Name:POU
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 1:4960 SW 72ND AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5506
Mailing Address - Country:US
Mailing Address - Phone:305-662-5200
Mailing Address - Fax:305-667-1275
Practice Address - Street 1:440 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3603
Practice Address - Country:US
Practice Address - Phone:305-828-5000
Practice Address - Fax:305-823-1635
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30635207V00000X
FLME116882207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3099456OtherBCBS
TN3828825Medicaid
TN3099456OtherBCBS
TN3828825Medicaid