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Organization

AQUA BLUE PEDIATRICS PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDON BETANCOURT (PRACTICE ADMINISTRATOR)
(847) 854-9402
Entity
Organization

Contact information

Practice address
785 W GRANADA BLVD STE 4, ORMOND BEACH, FL 32174-5163
(630) 464-4928
Mailing address
7901 4TH ST N # 30729, ST PETERSBURG, FL 33702-4305
(630) 464-4928
(847) 854-9403

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
02/10/2026
Last updated
02/10/2026
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