Healthcare Provider Details

I. General information

NPI: 1215718630
Provider Name (Legal Business Name): DANET ESPINOSA BETANCOURT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 10/11/2023
Certification Date: 10/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6042 SR- 200 E
OCALA FL
34476
US

IV. Provider business mailing address

4515 SW 98TH ST
OCALA FL
34476-4042
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-0984
  • Fax:
Mailing address:
  • Phone: 786-234-5549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS40504
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: