Individual provider Active NPI

Kwame Fosu Agyeman

  • Clinical Medical Laboratory
  • North Miami Beach, FL
National Provider Identifier
1801513064
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
2065 NE 163Rd St
North Miami Beach, FL 33162-4901
Phone
(786) 589-7215
NPI assigned
Oct 27, 2022
Reactivated
Oct 15, 2026
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

2065 NE 163Rd St
North Miami Beach, FL 33162-4901

Mailing address

2065 NE 163Rd St
North Miami Beach, FL 33162-4901
Phone (786) 589-7215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1801513064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2065 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624901",
            "telephone_number": "786-589-7215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2065 NE 163RD ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624901",
            "telephone_number": "786-589-7215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGYEMAN",
        "first_name": "KWAME",
        "middle_name": "FOSU",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-27",
        "last_updated": "2026-10-15",
        "certification_date": "2022-10-27",
        "deactivation_date": "2022-10-27",
        "reactivation_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.