1144906066 NPI number — BELTRAN PSYCHOLOGICAL SERIVCES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144906066 NPI number — BELTRAN PSYCHOLOGICAL SERIVCES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELTRAN PSYCHOLOGICAL SERIVCES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144906066
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
809 E OAK ST
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
KISSIMMEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34744-5834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-518-9161
Provider Business Mailing Address Fax Number:
407-518-9942

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BELTRAN PSYCHOLOGICAL SERIVCES
Provider Second Line Business Practice Location Address:
809 E OAK ST, SUITE 105
Provider Business Practice Location Address City Name:
KISSIMMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34744-5834
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-518-9161
Provider Business Practice Location Address Fax Number:
407-518-9942
Provider Enumeration Date:
06/26/2023

Additional Information

Authorized Official

Authorized Official Last Name:
BELTRAN
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PSYCHOLOGIST
Authorized Official Telephone Number:
407-518-9161

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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