Healthcare Provider Details

I. General information

NPI: 1629562848
Provider Name (Legal Business Name): YESSENIA MARIA MARTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4305 STEED TER
WINTER PARK FL
32792-7630
US

IV. Provider business mailing address

1969 S ALAFAYA TRL # 305
ORLANDO FL
32828-8732
US

V. Phone/Fax

Practice location:
  • Phone: 407-863-7980
  • Fax:
Mailing address:
  • Phone: 407-863-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME150192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: