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NPI Code Detail

MEDICARE: DR. GREGORY WAYNE BETTON MD

MEDICARE: DR. GREGORY WAYNE BETTON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianME80681FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
235744OTHERFLBLUCROSS BLUESHIELD

General Provider Information

NPI Number : 1528061660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY WAYNE BETTON MD
Provider Business Mailing Address
First Line : PO BOX 278
Second Line :
City : COCOA
State : FL
Zip : 32923-0278
Country : US
Telephone Number : 321-480-5017
Fax Number :
Provider Business Practice Location Address
First Line : 600 E DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-5925
Country : US
Telephone Number : 321-480-5017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 05/07/2008

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Directions to “ DR. GREGORY WAYNE BETTON MD” Practice Location

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