Healthcare Provider Details

I. General information

NPI: 1679494900
Provider Name (Legal Business Name): MARYAN BETANCOURT CAPLAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6191 ORANGE DR STE 6167
DAVIE FL
33314-3454
US

IV. Provider business mailing address

4921 SW 205TH AVE
SOUTHWEST RANCHES FL
33332-1043
US

V. Phone/Fax

Practice location:
  • Phone: 954-800-4078
  • Fax: 954-369-1444
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ13392
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: