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NPI Code Detail

MEDICARE: YASER OMAR MARTINEZ

MEDICARE: YASER OMAR MARTINEZ
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
1106S00000XBehavior TechnicianFL

General Provider Information

NPI Number : 1689537789
Entity Type Code : Individual
Provider Name (Legal Business Name) : YASER OMAR MARTINEZ
Provider Business Mailing Address
First Line : 1303 W GLADIOLA DR
Second Line :
City : AVON PARK
State : FL
Zip : 33825-9533
Country : US
Telephone Number : 863-773-8882
Fax Number :
Provider Business Practice Location Address
First Line : 1303 W GLADIOLA DR
Second Line :
City : AVON PARK
State : FL
Zip : 33825-9533
Country : US
Telephone Number : 863-773-8882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2025
Last Update Date : 12/05/2025

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Directions to “ YASER OMAR MARTINEZ ” Practice Location

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