NPIMap

Organization Active NPI

Bethsaida Healthcare System Inc

  • Adult Medicine Physician
  • Wildwood, FL
National Provider Identifier
1003385055
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
BETHSAIDA HEALTHCARE SYSTEM INC
Practice address
2986 County Road 503
Wildwood, FL 34785-8013
Phone
(352) 753-2224
Fax
(353) 753-0833
NPI assigned
Nov 20, 2018
Last updated
Jun 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Felix C Agbo, MDNPI 1215145610
Title
Owner
Phone
(352) 753-2224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Adult Medicine Physician 207QA0505X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

2986 County Road 503
Wildwood, FL 34785-8013

Mailing address

910 Old Camp Rd Ste 144
The Villages, FL 32162-5609
Phone (352) 753-2224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190409003177 FL Part B Supplier - Clinic/Group Practice 6406197946 Receives reassigned benefits from 13 practitioners
Practice locations: Wildwood, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1003385055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 OLD CAMP RD STE 144",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321625609",
            "telephone_number": "352-753-2224",
            "fax_number": "353-753-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2986 COUNTY ROAD 503",
            "city": "WILDWOOD",
            "state": "FL",
            "postal_code": "347858013",
            "telephone_number": "352-753-2224",
            "fax_number": "353-753-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHSAIDA HEALTHCARE SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-20",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "AGBO",
        "authorized_official_first_name": "FELIX",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-753-2224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.