Provider Information for 1760089833
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MERCY LEE BETTS
Sex: Female
NPI: 1760089833
Last Updated: 2020-10-02
Certification Date: 2020-10-02
Certification Date: 2020-10-02
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760089833 | ||||||||||||
| Enumeration Date | 2020-10-02 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 4161 TAMIAMI TRL STE 401 PORT CHARLOTTE, FL 33952-9254 United States Phone: 941-235-2710 | Fax:941-235-2712 | ||||||||||||
| Primary Practice Address | 4161 TAMIAMI TRL STE 401 PORT CHARLOTTE, FL 33952-9254 United States Phone: 941-235-2710 | Fax:941-235-2712 | ||||||||||||
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