Provider Demographics
NPI:1538874383
Name:OLMEDA TORRES, BETZALY
Entity type:Individual
Prefix:
First Name:BETZALY
Middle Name:
Last Name:OLMEDA TORRES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WOODPECKER CT
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-5233
Mailing Address - Country:US
Mailing Address - Phone:787-414-4613
Mailing Address - Fax:
Practice Address - Street 1:114 WOODPECKER CT
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5233
Practice Address - Country:US
Practice Address - Phone:787-414-4613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty