Individual
JOSELYN AGOSTO-BETANCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
EAST HIGHWAY 18 IHS COMPOUND, PINE RIDGE, SD 57770-1201
(787) 340-2029
Mailing address
912 CRIMSON CT, RAPID CITY, SD 57701-1778
(787) 340-2029
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17757
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17787
MEDICAL LICENSE
PR
Enumeration date
12/16/2009
Last updated
04/17/2020
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