Basic Information
| Provider Information | |||||||||
| NPI: | 1013570597 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POMARES CASTILLO | ||||||||
| FirstName: | REYNIER | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5961 NW 173RD DR | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330155114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055567500 | ||||||||
| FaxNumber: | 3058515708 | ||||||||
| Practice Location | |||||||||
| Address1: | 5961 NW 173RD DR | ||||||||
| Address2: | |||||||||
| City: | HIALEAH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330155114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055567500 | ||||||||
| FaxNumber: | 3058515708 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2019 | ||||||||
| LastUpdateDate: | 07/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/29/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | ME158245 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.