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General NPI Number Information
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NPI Number | 1063199057
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Entity Type | Individual
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Provider Name | JULIETE K BETANCOURT
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Gender | Female
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 18244 NW 27TH AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33056-3501
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Country | US
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Telephone | 305-454-0911
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Fax |
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Provider Business Mailing Address
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Address Line | 13922 SW 52ND ST
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City | MIRAMAR
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State | FL
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Zip | 33027-5955
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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