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General NPI Number Information
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NPI Number | 1346461464
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Entity Type | Individual
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Provider Name | BETZAIDA ELIZABETH ODIOTT MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/20/2018
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Provider Practice Location Address
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Address Line | CALLE 65 INFANTERIA #37
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City | ANASCO
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State | PR
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Zip | 00610
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Country | US
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Telephone | 787-264-9503
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 3120
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City | BOQUERON
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State | PR
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Zip | 00622-9712
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Country | US
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Telephone | 787-364-0503
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 14733
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License Number State | PR
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