Healthcare Provider Details

I. General information

NPI: 1255964011
Provider Name (Legal Business Name): NATALIA BETANCOURT BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NW 89TH PL STE 113
DORAL FL
33172-2618
US

IV. Provider business mailing address

457 NE 6TH PL
FLORIDA CITY FL
33034-3267
US

V. Phone/Fax

Practice location:
  • Phone: 305-562-1983
  • Fax:
Mailing address:
  • Phone: 305-562-1983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86132
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: