Doctor Name: | MS. LISETTE MARIE BETANCOURT |
NPI Number: | 1033365903 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SA1963 |
Business Practice Address: | 3100 Sw 62nd Ave Miami, FL - 331553009 |
Business Phone Number: | 3056666511 |
Business Fax Number: | 3056629633 |
Mailing Address: | 3100 Sw 62nd Ave, MIAMI |
State: | FL |
Postal Code: | 331553009 |
Phone Number: | 3056666511 |
Fax Number: | 3056629633 |
NPI Enumeration Date: | 08/12/2008 |
NPI Last Update Date: | 08/12/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA1963 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |