Provider Demographics
NPI:1891995098
Name:JOSE E BETANCOURT MD PA
Entity Type:Organization
Organization Name:JOSE E BETANCOURT MD PA
Other - Org Name:CARDIAC ARRHYTHMIA INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ERNESTO
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-546-9565
Mailing Address - Street 1:18063 NW 87TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6720
Mailing Address - Country:US
Mailing Address - Phone:305-546-9565
Mailing Address - Fax:786-363-8587
Practice Address - Street 1:13903 NW 67TH AVE STE 250
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2938
Practice Address - Country:US
Practice Address - Phone:786-363-8587
Practice Address - Fax:786-363-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92730207R00000X
261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty