Healthcare Provider Details

I. General information

NPI: 1083524284
Provider Name (Legal Business Name): YAMAIRA D BETANCOURT SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13907 N DALE MABRY HWY STE 214
TAMPA FL
33618-2411
US

IV. Provider business mailing address

13907 N DALE MABRY HWY STE 214
TAMPA FL
33618-2411
US

V. Phone/Fax

Practice location:
  • Phone: 321-948-9548
  • Fax:
Mailing address:
  • Phone: 321-948-9548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI8242
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: