Provider Demographics
NPI:1730398389
Name:FLORIO, BETTYE RHO-NAN (SPEECH LANGUAGE PATH)
Entity type:Individual
Prefix:MRS
First Name:BETTYE
Middle Name:RHO-NAN
Last Name:FLORIO
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5129 SE 105TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:34420-3146
Mailing Address - Country:US
Mailing Address - Phone:352-245-3147
Mailing Address - Fax:
Practice Address - Street 1:5129 SE 105TH PL
Practice Address - Street 2:
Practice Address - City:BELLEVIEW
Practice Address - State:FL
Practice Address - Zip Code:34420-3146
Practice Address - Country:US
Practice Address - Phone:352-245-3147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2023-01-27
Deactivation Date:2022-12-05
Deactivation Code:
Reactivation Date:2023-01-12
Provider Licenses
StateLicense IDTaxonomies
FLSA 8733235Z00000X
FLRBT22243758106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891825200Medicaid