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NPI Code Detail

MEDICARE: JEAN EMIL BETANCOURT VIETA APRN

MEDICARE: JEAN EMIL BETANCOURT VIETA APRN
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
1363LF0000XFamily Nurse PractitionerRN9332807FL
2363LF0000XFamily Nurse Practitioner9332807FL
3363L00000XNurse PractitionerAPRN9332807FL

Other Identifiers

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

General Provider Information

NPI Number : 1609362144
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN EMIL BETANCOURT VIETA APRN
Provider Business Mailing Address
First Line : 445 NW 4TH ST APT 1001
Second Line :
City : MIAMI
State : FL
Zip : 33128-1704
Country : US
Telephone Number : 786-419-2166
Fax Number :
Provider Business Practice Location Address
First Line : 1150 NW 14TH ST STE 309
Second Line :
City : MIAMI
State : FL
Zip : 33136-2114
Country : US
Telephone Number : 305-243-4562
Fax Number : 305-243-3381
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2018
Last Update Date : 12/11/2018

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