Provider Demographics
NPI:1952361719
Name:BETANCUR, ADRIANA E (CNA)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANA
Middle Name:E
Last Name:BETANCUR
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11805 BRENFORD CREST DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-4050
Mailing Address - Country:US
Mailing Address - Phone:813-677-8493
Mailing Address - Fax:
Practice Address - Street 1:11805 BRENFORD CREST DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-4050
Practice Address - Country:US
Practice Address - Phone:813-677-8493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 58597372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider