Provider Demographics
NPI:1710427802
Name:POMALES, ASHLEY HILAL
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:HILAL
Last Name:POMALES
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 1:482 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4189
Mailing Address - Country:US
Mailing Address - Phone:321-948-6891
Mailing Address - Fax:
Practice Address - Street 1:482 FREEMAN ST
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4189
Practice Address - Country:US
Practice Address - Phone:321-948-6891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9331645363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily