Dr. Gustavo Rafael Betancourt, MD
Physician Assistant, Surgical in Kissimmee, FL. Individual provider (NPI-1).
NPI number1407477649
StatusActive
Last updated in NPPESMay 18, 2026
Details
- NPI
- 1407477649
- Entity type
- Individual (NPI-1)
- Name
- Dr. Gustavo Rafael Betancourt
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 28, 2020
- Certification date
- May 18, 2026
- Last updated
- May 18, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 21-496 | FL | Yes |
| 207Q00000X | Family Medicine | NJDCATEMP015064 | NJ |
Practice location
4319 Creeks Run BlvdKissimmee, FL 34746-2314
Phone 407-961-9822
Mailing address
401 University Blvd WSilver Spring, MD 20901-2026
Phone 407-961-9822
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All 16 Surgical Physician Assistant providers in Kissimmee · All 7,630 providers in Kissimmee
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