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General NPI Number Information
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NPI Number | 1205455896
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Entity Type | Individual
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Provider Name | YUNIESKY MARTINEZLOPEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 1700 SAND LAKE RD STE D114
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City | ORLANDO
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State | FL
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Zip | 32809-9149
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Country | US
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Telephone | 407-517-5510
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Fax |
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Provider Business Mailing Address
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Address Line | 1324 ZAPATA CT
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-4806
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Country | US
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Telephone | 727-623-3279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN27372
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License Number State | FL
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