Provider Demographics
NPI:1073181269
Name:AGAPE TRINITY WELLNESS & HEALTH
Entity Type:Organization
Organization Name:AGAPE TRINITY WELLNESS & HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:239-398-4479
Mailing Address - Street 1:7795 DAVIS BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5373
Mailing Address - Country:US
Mailing Address - Phone:239-398-4479
Mailing Address - Fax:
Practice Address - Street 1:7795 DAVIS BLVD STE 206
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-5373
Practice Address - Country:US
Practice Address - Phone:239-398-4479
Practice Address - Fax:239-455-1882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty