Healthcare Provider Details

I. General information

NPI: 1639561186
Provider Name (Legal Business Name): AGAPEMD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90130 OLD HWY
TAVERNIER FL
33070-2368
US

IV. Provider business mailing address

101425 OVERSEAS HWY # 190
KEY LARGO FL
33037-4505
US

V. Phone/Fax

Practice location:
  • Phone: 305-852-9300
  • Fax: 305-853-1260
Mailing address:
  • Phone: 786-339-4683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberL14000072508
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberL14000072508
License Number StateFL

VIII. Authorized Official

Name: BETHZAIRA DIAZ
Title or Position: OWNER
Credential:
Phone: 786-339-4683