Agate Healthcare Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AGATE HEALTHCARE SERVICES LLC

Practice address

13410 Parker Commons Blvd Ste 103E
Fort Myers, FL 33912-1867

Phone

(239) 766-2770

Fax

(239) 365-1500

NPI assigned

Aug 25, 2022

Organization subpart

No

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

Authorized official

Name

Kathia O Abba Gana

Title

Administrator

Phone

(239) 766-2778

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1215656996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13410 PARKER COMMONS BLVD STE 103E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121867",
            "telephone_number": "239-766-2778",
            "fax_number": "239-365-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13410 PARKER COMMONS BLVD STE 103E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121867",
            "telephone_number": "239-766-2770",
            "fax_number": "239-365-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGATE HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-25",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "ABBA GANA",
        "authorized_official_first_name": "KATHIA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "239-766-2778"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.