MEDICARE: DR. YARELIS CARTAGENA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN 18885	FL

General Provider Information

NPI Number	:	1205077013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YARELIS CARTAGENA DMD

Provider Business Mailing Address
First Line	:	3685 FALLSCREST CIR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6672
Country	:	US
Telephone Number	:	787-344-0087
Fax Number	:	863-607-4434

Provider Business Practice Location Address
First Line	:	3436 S FLORIDA AVE
Second Line	:	SUITE 100
City	:	LAKELAND
State	:	FL
Zip	:	33803-4765
Country	:	US
Telephone Number	:	863-607-4700
Fax Number	:	863-607-4434

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2009
Last Update Date	:	04/17/2013

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