MEDICARE: AGAPE NURSE REGISTRY

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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922512094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGAPE NURSE REGISTRY

Provider Business Mailing Address
First Line	:	3802 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4127
Country	:	US
Telephone Number	:	786-314-2422
Fax Number	:	305-270-7114

Provider Business Practice Location Address
First Line	:	3802 W 12TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4127
Country	:	US
Telephone Number	:	786-314-2422
Fax Number	:	305-270-7114

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LEYDI LISETTE MARTINEZ
Credential	:
Telephone Number	:	786-970-0293

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	09/21/2022

Similar Medicare Providers

1760077648 — DIANA GOMEZ RBT
Practice Location Address:

4127 W 9TH CT
HIALEAH, FL
33012-7201

Practice Phone: 305-988-2773
Practice Fax:

1114633237 — LA FAMILIA MEDICAL CENTER II HIALEAH CORP.
Practice Location Address:

3824 W 12TH AVE
HIALEAH, FL
33012-4127

Practice Phone: 786-547-5527
Practice Fax:

1689482523 — RICARDO ALFREDO SUAREZ PEREZ APRN/FNP
Practice Location Address:

3824 W 12TH AVE
HIALEAH, FL
33012-4127

Practice Phone: 305-643-0550
Practice Fax:

1821964198 — NAVARRO MEDICAL CENTERS LLC
Practice Location Address:

3824 W 12TH AVE
HIALEAH, FL
33012-4127

Practice Phone: 786-332-4577
Practice Fax:

1215605829 — MAYVIT GORDILLO
Practice Location Address:

795 W 78TH ST
HIALEAH, FL
33014-4127

Practice Phone: 786-384-0364
Practice Fax:

1235905621 — KENNY CARVAJAL
Practice Location Address:

465 E 19TH ST
HIALEAH, FL
33013-4127

Practice Phone: 786-406-4660
Practice Fax:

Directions to “AGAPE NURSE REGISTRY ” 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 © 2007-2026 (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.