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General NPI Number Information
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NPI Number | 1215656996
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Entity Type | Organization
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Legal Business Name | AGATE HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 08/25/2022
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 13410 PARKER COMMONS BLVD STE 103E
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City | FORT MYERS
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State | FL
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Zip | 33912-1867
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Country | US
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Telephone | 239-766-2770
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Fax | 239-365-1500
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Provider Business Mailing Address
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Address Line | 13410 PARKER COMMONS BLVD STE 103E
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City | FORT MYERS
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State | FL
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Zip | 33912-1867
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Country | US
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Telephone | 239-766-2778
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Fax | 239-365-1500
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KATHIA O ABBA GANA
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Credential |
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Telephone | 239-766-2778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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