Provider Demographics
NPI:1508137563
Name:BETTINGER, JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:BETTINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 S BAYSHORE DR
Mailing Address - Street 2:VILLA 45
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-3256
Mailing Address - Country:US
Mailing Address - Phone:305-860-3098
Mailing Address - Fax:305-860-3099
Practice Address - Street 1:2000 S BAYSHORE DR
Practice Address - Street 2:VILLA 45
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-3256
Practice Address - Country:US
Practice Address - Phone:305-860-3098
Practice Address - Fax:305-860-3099
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME26458207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine