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General NPI Number Information
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NPI Number | 1558116806
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Entity Type | Organization
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Legal Business Name | BETANCOURTAPRNPRIMARYHEALTHCARE.LLC
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Dates
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Enumeration Date | 04/20/2024
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Last Update Date | 04/20/2024
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Provider Practice Location Address
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Address Line | 4742 BLOSSOM DR
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City | HOLIDAY
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State | FL
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Zip | 34690-3901
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Country | US
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Telephone | 786-616-6409
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Fax |
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Provider Business Mailing Address
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Address Line | 4742 BLOSSOM DR
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City | HOLIDAY
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State | FL
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Zip | 34690-3901
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Country | US
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Telephone | 786-616-6409
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Fax |
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Authorized Official
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Title or Position | APRN,FNP
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Name | ORLANDO BETANCOURT SANZ
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Credential | APRN,FNP
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Telephone | 786-616-6409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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