Provider Demographics
NPI:1033930326
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:PRESIDENT
Authorized Official - Prefix:DR
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:954-989-3333
Mailing Address - Street 1:5700 STIRLING RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1522
Mailing Address - Country:US
Mailing Address - Phone:954-989-3333
Mailing Address - Fax:786-762-2926
Practice Address - Street 1:5700 STIRLING RD STE 300
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-1522
Practice Address - Country:US
Practice Address - Phone:954-989-3333
Practice Address - Fax:786-762-2926
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KERI M POMELLA, OD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty