MEDICARE: MRS. FUNMILAYO A AGENE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202207758	VA

General Provider Information

NPI Number	:	1912289067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FUNMILAYO A AGENE

Provider Business Mailing Address
First Line	:	801 INDEPENDENCE BLVD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6003
Country	:	US
Telephone Number	:	757-519-9877
Fax Number	:	757-519-9894

Provider Business Practice Location Address
First Line	:	2348 FENWICK WAY
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-2872
Country	:	US
Telephone Number	:	757-450-2301
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	09/27/2021

Similar Medicare Providers

1417511841 — BROWNS TENDER-HEARTED CARE
Practice Location Address:

116 VIRGINIA LN
CLIMAX, GA
39834-2872

Practice Phone: 229-726-4137
Practice Fax:

1760699755 — MRS. CYNTHIA S. BELTRANO P.T.
Practice Location Address:

11911 US HIGHWAY 1 STE 102
NORTH PALM BEACH, FL
33408-2872

Practice Phone: 561-626-5433
Practice Fax: 591-626-3371

1104080167 — DR. NHIEN THUY LUU D.D.S.
Practice Location Address:

407 N PACIFIC COAST HWY STE 392
REDONDO BEACH, CA
90277-2872

Practice Phone: 424-257-0717
Practice Fax:

1164865531 — PALM PEDIATRIC THERAPY
Practice Location Address:

11911 US HIGHWAY 1 STE 102
NORTH PALM BEACH, FL
33408-2872

Practice Phone: 561-694-7661
Practice Fax:

1962846709 — KC PBG HEALTH CENTER, LLC
Practice Location Address:

3600 MASTERPIECE WAY
PALM BEACH GARDENS, FL
33410-2872

Practice Phone: 561-514-5000
Practice Fax:

1225434814 — MISS LESLIE ANN KELLY M.S., CCC-SLP
Practice Location Address:

11911 US HIGHWAY 1 STE 102
NORTH PALM BEACH, FL
33408-2872

Practice Phone: 561-694-7661
Practice Fax:

Directions to “ MRS. FUNMILAYO A AGENE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.