Provider Demographics
NPI:1528613866
Name:BETANCOURT THERAPY CORP
Entity type:Organization
Organization Name:BETANCOURT THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:YULEYDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BETANCOURT MESA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, SLP
Authorized Official - Phone:786-380-7385
Mailing Address - Street 1:6156 SW 158TH PASS
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3696
Mailing Address - Country:US
Mailing Address - Phone:786-380-7385
Mailing Address - Fax:
Practice Address - Street 1:6156 SW 158TH PASS
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3696
Practice Address - Country:US
Practice Address - Phone:786-380-7385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty