Individual
DR. BETINA P. LAIOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7599 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884
(863) 324-4725
(863) 324-4783
Mailing address
7599 CYPRESS GARDENS BLVD, WINTER HAVEN, FL 33884-3263
(863) 324-4725
(863) 229-7514
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME109722
FL
208D00000X
General Practice Physician
2007032916
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010626
GROUP PTAN
MO
01
—
1275716573
SITE NPI
MO
05
—
207022609
—
MO
01
—
331150626
PTAN
MO
01
—
ME109722
LICENSE
FL
Enumeration date
12/10/2007
Last updated
04/18/2022
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