| Agape Health & Wellness Center Inc. | |
|
6138 Kennerly Rd Ste And150 Jacksonville FL 32216-4393 | |
| (386) 283-2010 | |
| Not Available |
| Full Name | Agape Health & Wellness Center Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6138 Kennerly Rd Ste And150, Jacksonville, Florida |
| Authorized Official Name and Position | Tiffany Hart (CREDENTIALING/BILLING MANAGER) |
| Authorized Official Contact | 9043007494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Health & Wellness Center Inc. 11555 Central Pkwy Ste 601 Jacksonville FL 32224-2698 Ph: (386) 283-2010 | Agape Health & Wellness Center Inc. 6138 Kennerly Rd Ste And150 Jacksonville FL 32216-4393 Ph: (386) 283-2010 |
| NPI Number | 1386223469 |
|---|---|
| Provider Enumeration Date | 04/06/2021 |
| Last Update Date | 04/19/2024 |
| Certification Date | 04/19/2024 |
| Medicare PECOS PAC ID | 0547616815 |
|---|---|
| Medicare Enrollment ID | O20231023001440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386223469 | NPI | - | NPPES |
| 2575228 | Medicaid | FL |
| Provider Name | Carlos Torrellas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245394832 PECOS PAC ID: 7810881992 Enrollment ID: I20040210000671 |
| Provider Name | Raul Soto-acosta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619991106 PECOS PAC ID: 5799727228 Enrollment ID: I20050525000572 |
| Provider Name | Pablo M Pella |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245347004 PECOS PAC ID: 2668453671 Enrollment ID: I20101019000130 |
| Provider Name | Crystalene D Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811287295 PECOS PAC ID: 4082892708 Enrollment ID: I20110629000205 |
| Provider Name | Laverne Dowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306222419 PECOS PAC ID: 7618165952 Enrollment ID: I20151001001345 |
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