Healthcare Provider Details

I. General information

NPI: 1982696746
Provider Name (Legal Business Name): MARIA CRISTINA BETANCOURT QUILES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 AVE 177 LOMAS VERDES ESQ YANGTZE
SAN JUAN PR
00926-6901
US

IV. Provider business mailing address

PIO BAROJA 333 EL SENORIAL
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-244-8224
  • Fax: 787-790-6671
Mailing address:
  • Phone: 787-428-8133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number16146
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: