Healthcare Provider Details

I. General information

NPI: 1871371054
Provider Name (Legal Business Name): YENISBEL MARTINEZ PEREZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 US HIGHWAY 441 N
OKEECHOBEE FL
34972-1901
US

IV. Provider business mailing address

5827 CORPORATE WAY
WEST PALM BEACH FL
33407-2000
US

V. Phone/Fax

Practice location:
  • Phone: 863-763-1951
  • Fax: 844-540-4798
Mailing address:
  • Phone: 561-844-9443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN28593
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: