Provider Demographics
NPI:1285616516
Name:BETANCOURT-PINEIRO, MARIA LOURDES (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LOURDES
Last Name:BETANCOURT-PINEIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270334
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-0334
Mailing Address - Country:US
Mailing Address - Phone:787-793-3095
Mailing Address - Fax:787-782-9368
Practice Address - Street 1:URB LANDRAU
Practice Address - Street 2:1411 CARR 21
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921-3408
Practice Address - Country:US
Practice Address - Phone:787-793-3095
Practice Address - Fax:787-782-9368
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-14
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6418207N00000X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
8000503OtherHUMANA PR
PE0563OtherPALIC
068131OtherCA
97846BEOtherSSS
068131OtherCA
PE0563OtherPALIC