Provider Demographics
NPI:1205077013
Name:CARTAGENA, YARELIS (DMD)
Entity type:Individual
Prefix:DR
First Name:YARELIS
Middle Name:
Last Name:CARTAGENA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3685 FALLSCREST CIR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-6672
Mailing Address - Country:US
Mailing Address - Phone:787-344-0087
Mailing Address - Fax:863-607-4434
Practice Address - Street 1:3436 S FLORIDA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4765
Practice Address - Country:US
Practice Address - Phone:863-607-4700
Practice Address - Fax:863-607-4434
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 188851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice