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NPI Code Detail

MEDICARE: BETTINA GARCON

MEDICARE: BETTINA GARCON
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
12355S0801XSpeech-Language AssistantSI2176FL

General Provider Information

NPI Number : 1811323298
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTINA GARCON
Provider Business Mailing Address
First Line : 3039 SE WAKE RD
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34984-6350
Country : US
Telephone Number : 772-224-6749
Fax Number :
Provider Business Practice Location Address
First Line : 4715 KIRBY LOOP RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5345
Country : US
Telephone Number : 772-224-6749
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2013
Last Update Date : 09/17/2013

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Directions to “ BETTINA GARCON ” Practice Location

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