Individual provider Active NPI

Rolando R. Betancourt de Leon

  • Registered Nurse
  • San Juan, PR
National Provider Identifier
1205595782
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
3069 Issued in PR
Practice address
Ave Ponce de Leon
560 Hato Rey
San Juan, PR 00918
Phone
(787) 765-3560
NPI assigned
Dec 13, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 3069 PR Primary

Addresses

Primary practice location

Ave Ponce de Leon
560 Hato Rey
San Juan, PR 00918

Mailing address

Urb. Beverly Hills
Camino Tortugo 34
San Juan, PR 00926

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3069PRMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fuentes Medical Center Corp CurrentSince Dec 21, 2025 Accepting new patients
Edp T Cuida PastSince Jun 4, 2023 Accepting new patients

Locations

560 Ave Ponce de Leon
San Juan, PR 00918
Phone (786) 515-5592

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1205595782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. BEVERLY HILLS",
            "address_2": "CAMINO TORTUGO 34",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE PONCE DE LEON",
            "address_2": "560 HATO REY",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-765-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT DE LEON",
        "first_name": "ROLANDO",
        "middle_name": "R.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.