Organization
OASIS BEHAVIORAL HEALTH LLC
Active
Other names
Spark Wellness Group
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS EMILIO BETANCOURT MD (CO-OWNER)
(704) 770-7027
Entity
Organization
Contact information
Practice address
6900 TAVISTOCK LAKES BLVD STE 400-412, ORLANDO, FL 32827-7589
(321) 340-3490
(321) 340-4755
Mailing address
10026 HATTON CIR, ORLANDO, FL 32832-6174
(321) 340-3490
(321) 340-4755
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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