Agape Nurse Registry

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

AGAPE NURSE REGISTRY

Practice address

3802 W 12TH Ave
Hialeah, FL 33012-4127

Phone

(786) 314-2422

Fax

(305) 270-7114

NPI assigned

Nov 27, 2017

Last updated

Sep 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Leydi Lisette Martinez

Title

President

Phone

(786) 970-0293

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1922512094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 W 12TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124127",
            "telephone_number": "786-314-2422",
            "fax_number": "305-270-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 W 12TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124127",
            "telephone_number": "786-314-2422",
            "fax_number": "305-270-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGAPE NURSE REGISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-27",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LEYDI",
        "authorized_official_middle_name": "LISETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-970-0293"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10077300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.