Healthcare Provider Details

I. General information

NPI: 1417811589
Provider Name (Legal Business Name): YANELIS MARTINEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 E SILVER SPRINGS BLVD
OCALA FL
34470-6831
US

IV. Provider business mailing address

15580 SW 46TH CIR
OCALA FL
34473-3181
US

V. Phone/Fax

Practice location:
  • Phone: 352-342-3839
  • Fax:
Mailing address:
  • Phone: 806-223-5749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: