Healthcare Provider Details

I. General information

NPI: 1891563672
Provider Name (Legal Business Name): YONIEL ENRIQUE FERMIN POLANCO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 ROCK SPRINGS RD
APOPKA FL
32712-2306
US

IV. Provider business mailing address

1450 ROCK SPRINGS RD
APOPKA FL
32712-2306
US

V. Phone/Fax

Practice location:
  • Phone: 407-814-4940
  • Fax:
Mailing address:
  • Phone: 347-635-4331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32100
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: