Doctor Name: | DR. LUIS F BETANCOURT MEDINA |
NPI Number: | 1184835738 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 9223 |
Business Practice Address: | 4100 Ste 222 Ave Arcadio Estrada San Sebastian Office Building San Sebastian, PR - 00685 |
Business Phone Number: | 7878963165 |
Business Fax Number: | 7872800330 |
Mailing Address: | Po Box 549, Villas De Piedras Blancas SAN SEBASTIAN |
State: | PR |
Postal Code: | 006850549 |
Phone Number: | 7874795168 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 9223 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |