Provider Demographics
NPI:1831623065
Name:AGAPE HEART TO HEART
Entity type:Organization
Organization Name:AGAPE HEART TO HEART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP-C
Authorized Official - Phone:239-398-4479
Mailing Address - Street 1:6615 HILLWAY CIR STE 201
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-8755
Mailing Address - Country:US
Mailing Address - Phone:239-315-0612
Mailing Address - Fax:
Practice Address - Street 1:6615 HILLWAY CIR STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-8755
Practice Address - Country:US
Practice Address - Phone:239-315-0612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-14
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service