Healthcare Provider Details

I. General information

NPI: 1477341527
Provider Name (Legal Business Name): BETTIE CIUS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 20TH ST BLDG C
VERO BEACH FL
32960-2400
US

IV. Provider business mailing address

784 NW BAYARD AVE
PORT SAINT LUCIE FL
34983-1069
US

V. Phone/Fax

Practice location:
  • Phone: 772-299-3003
  • Fax: 772-299-3005
Mailing address:
  • Phone: 561-360-8875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11039086
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: