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NPI Code Detail

MEDICARE: NORA DIANA BETANCOURT

MEDICARE:   NORA DIANA BETANCOURT
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
1103T00000XPsychologist
2222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1659497840
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORA DIANA BETANCOURT
Provider Business Mailing Address
First Line : 11023 N KENDALL DR APT M101
Second Line :
City : MIAMI
State : FL
Zip : 33176-1296
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 536 CORAL WAY
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4915
Country : US
Telephone Number : 305-445-0475
Fax Number : 305-445-1830
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 06/18/2010

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Directions to “ NORA DIANA BETANCOURT ” Practice Location

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