Elias Betancourt

Individual provider Active NPI Other Technician · Patillas, PR

NPI 1013227529 · NPPES record last updated Jan 12, 2011

Key facts

NPI
1013227529
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
License
595 (PR)
Practice address
17 Calle Santiago Iglesias
Patillas, PR 00723-2603
Phone
(787) 374-0106
NPI assigned
Oct 18, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
595PRMDAudiologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X 595 PR Yes

Addresses

Primary practice location

17 Calle Santiago Iglesias
Patillas, PR 00723-2603

Mailing address

17 Santiago Iglesias
Patillas, PR 00723
UM
Phone (787) 374-0106

Other providers in Patillas, PR

All providers in Patillas, PR · Other Technician in Puerto Rico

Sources for this page

Verify at the official NPI Registry.