Betancourt, Gustavo Rafael

Betancourt, Gustavo Rafael is an sole proprietor health care provider with primary practice located at 4319 Creeks Run Blvd , Kissimmee FL 34746-2314. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Allopathic & Osteopathic Physicians / Family Medicine. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Betancourt, Gustavo Rafael can be contacted via phone (407) 961-9822.

Contact Information

Primary practice address
4319 Creeks Run Blvd Kissimmee FL 34746-2314
Phone: (407) 961-9822
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 21-496 Florida
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X NJDCATEMP015064 New Jersey

Profile Details

NPI number 1407477649
LBN Legal business name Betancourt, Gustavo Rafael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 28th, 2020
Last updated May 18th, 2026 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1407477649 NPPES
New Jersey Other NJDCATEMP015064 MD

Popular Providers