Provider Demographics
NPI:1164313300
Name:TRAVIESO MARTINEZ, YAMILA (RDH)
Entity type:Individual
Prefix:
First Name:YAMILA
Middle Name:
Last Name:TRAVIESO MARTINEZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 JERSEY RD W
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6230
Mailing Address - Country:US
Mailing Address - Phone:754-271-7175
Mailing Address - Fax:
Practice Address - Street 1:305 JERSEY RD W
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6230
Practice Address - Country:US
Practice Address - Phone:754-271-7175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH34040124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist