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General NPI Number Information
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NPI Number | 1982289732
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Entity Type | Individual
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Provider Name | JORGE ARMANDO BETANCOURT
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Gender | Male
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Dates
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Enumeration Date | 03/12/2021
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Last Update Date | 03/31/2023
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Provider Practice Location Address
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Address Line | 14919 SW 80TH ST APT 203
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City | MIAMI
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State | FL
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Zip | 33193-3151
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Country | US
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Telephone | 305-877-6383
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Fax |
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Provider Business Mailing Address
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Address Line | 14919 SW 80TH ST APT 203
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City | MIAMI
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State | FL
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Zip | 33193-3151
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Country | US
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Telephone | 305-877-6383
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | 20-118422
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License Number State | FL
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