Individual provider Active NPI

Julia Lauren Betancourt

  • Anesthesiologist Assistant
  • Port Saint Lucie, FL
National Provider Identifier
1609780394
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
Practice address
1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521
Phone
(772) 335-4000
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X FL Primary

Addresses

Primary practice location

1800 SE Tiffany Ave
Port Saint Lucie, FL 34952-7521

Mailing address

10461 SW 16TH PL
Davie, FL 33324-7456
Phone (954) 812-8656

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1609780394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10461 SW 16TH PL",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333247456",
            "telephone_number": "954-812-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SE TIFFANY AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527521",
            "telephone_number": "772-335-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETANCOURT",
        "first_name": "JULIA",
        "middle_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.