Active NPI
Icel Betancourt, PHARM.D
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Miami, FL
National Provider Identifier
1710229869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PS35882
- Practice address
- 870 NW 106TH Ave
Miami, FL 33172-3129 - Phone
- (305) 608-5875
- NPI assigned
- Mar 26, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PU5530 | FL | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PS35882 | FL | Primary |
Addresses
Primary practice location
870 NW 106TH Ave
Miami, FL 33172-3129
Mailing address
870 NW 106TH Ave
Miami, FL 33172-3129
Phone (305) 608-5875
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PU5530 | FL | MD | Pharmacist |
| PS35882 | FL | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364256000000",
"number": "1710229869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "870 NW 106TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331723129",
"telephone_number": "305-608-5875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "870 NW 106TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331723129",
"telephone_number": "305-608-5875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETANCOURT",
"first_name": "ICEL",
"name_prefix": "Miss",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-26",
"last_updated": "2013-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PU5530",
"primary": false
},
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "FL",
"license": "PS35882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.