Individual provider · Type 1 NPI

Gustavo Rafael Betancourt, MD

Surgical Physician Assistant · Kissimmee, FL

NPI number 1407477649 Active · reactivated Mar 31, 2026

Practice location

4319 Creeks Run Blvd
Kissimmee, FL 34746-2314

Call (407) 961-9822 Map

Mailing address

401 University Blvd W
Silver Spring, MD 20901-2026

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X21-496 (FL)
Family Medicine Physician 207Q00000XNJDCATEMP015064 (NJ)

Surgical Physician Assistant: Definition to come...

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About NPI 1407477649

Gustavo Rafael Betancourt, MD's National Provider Identifier is 1407477649, issued on Apr 28, 2020. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Kissimmee, FL. The record was last updated on May 18, 2026.