Provider Demographics
NPI:1518020346
Name:BETANCOURT, CHRISTINE (OT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BETANCOURT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 SW 80TH ST
Mailing Address - Street 2:#107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4661
Mailing Address - Country:US
Mailing Address - Phone:305-283-8378
Mailing Address - Fax:
Practice Address - Street 1:6601 SW 80TH ST
Practice Address - Street 2:#107
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4661
Practice Address - Country:US
Practice Address - Phone:305-680-9707
Practice Address - Fax:305-680-9707
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11756225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics