Provider Demographics
NPI:1518640051
Name:POMARES GIL, LUZ ELENA
Entity Type:Individual
Prefix:DR
First Name:LUZ
Middle Name:ELENA
Last Name:POMARES GIL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5831 SW 9TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5050
Mailing Address - Country:US
Mailing Address - Phone:786-473-6592
Mailing Address - Fax:
Practice Address - Street 1:5831 SW 9TH ST APT 5
Practice Address - Street 2:
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5050
Practice Address - Country:US
Practice Address - Phone:786-473-6592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11024280363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily