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NPI Code Detail

MEDICARE: YARELIS CARTAGENA DMD, PA

MEDICARE: YARELIS CARTAGENA DMD, PA
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
11223G0001XGeneral Practice Dentistry18885FL

General Provider Information

NPI Number : 1245572239
Entity Type Code : Organization
Provider Name (Legal Business Name) : YARELIS CARTAGENA DMD, PA
Provider Business Mailing Address
First Line : PO BOX 3189
Second Line :
City : SYRACUSE
State : NY
Zip : 13220-3189
Country : US
Telephone Number : 866-273-8204
Fax Number : 866-803-4943
Provider Business Practice Location Address
First Line : 3436 S FLORIDA AVE
Second Line :
City : LAKELAND
State : FL
Zip : 33803-4765
Country : US
Telephone Number : 863-607-4700
Fax Number : 863-607-4434
Authorized Official
Title or Position : VP INSURANCE OPPS
Name : AMY MARKO
Credential :
Telephone Number : 866-273-8204
Provider Enumeration Date : 03/18/2013
Last Update Date : 03/18/2013

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Directions to “YARELIS CARTAGENA DMD, PA ” Practice Location

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