| NPI | 1629041405 |
|---|---|
| Former Name | JUANITA BETANCOURT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP1372732) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL ARNP1372732) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2012-12-17 |