Provider Demographics
NPI:1578264990
Name:KERI M POMELLA, OD PA
Entity Type:Organization
Organization Name:KERI M POMELLA, OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:POMELLA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-434-5500
Mailing Address - Street 1:9950 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3420
Mailing Address - Country:US
Mailing Address - Phone:954-434-5500
Mailing Address - Fax:786-762-2926
Practice Address - Street 1:9950 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3420
Practice Address - Country:US
Practice Address - Phone:954-434-5500
Practice Address - Fax:786-762-2926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KERI M. POMELLA O.D, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty