Healthcare Provider Details

I. General information

NPI: 1396250791
Provider Name (Legal Business Name): NATALIA BETANCOURT-GUZMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

IV. Provider business mailing address

4845 ALAMEDA AVE
EL PASO TX
79905-2705
US

V. Phone/Fax

Practice location:
  • Phone: 915-298-5444
  • Fax:
Mailing address:
  • Phone: 787-518-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15256
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15256I
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number71778
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberV9002
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: