Provider Demographics
NPI:1528589181
Name:AGAPE HEALTHCARE GROUP, CORP
Entity Type:Organization
Organization Name:AGAPE HEALTHCARE GROUP, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAGALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWLAND
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:954-667-5683
Mailing Address - Street 1:8517 NW 28TH CT
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5319
Mailing Address - Country:US
Mailing Address - Phone:954-667-5683
Mailing Address - Fax:
Practice Address - Street 1:8517 NW 28TH CT
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5319
Practice Address - Country:US
Practice Address - Phone:954-825-8914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1720224546Medicaid