Individual provider · Type 1 NPI

Mayra A. Betancourt Ponce, MD

Student in an Organized Health Care Education/Training Program · La Crosse, WI

NPI number 1154121002 Active

Practice location

1836 South Ave
La Crosse, WI 54601-5429

Call (608) 782-7300 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1154121002

Mayra A. Betancourt Ponce, MD's National Provider Identifier is 1154121002, issued on Mar 18, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in La Crosse, WI. The record was last updated on Jul 9, 2026.