| Agape Network, Inc. | |
|
22790 S.w. 112 Avenue Miami FL 33170-7602 | |
| (305) 235-2616 | |
| (305) 235-6178 |
| Full Name | Agape Network, Inc. |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 22790 S.w. 112 Avenue, Miami, Florida |
| Authorized Official Name and Position | Terry S. Lull (PROGRAM COORDINATOR) |
| Authorized Official Contact | 5619727771 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Agape Network, Inc. 22790 S.w. 112 Avenue Miami FL 33170-7602 Ph: (305) 235-2616 | Agape Network, Inc. 22790 S.w. 112 Avenue Miami FL 33170-7602 Ph: (305) 235-2616 |
| NPI Number | 1326191156 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 01/25/2024 |
| Certification Date | 01/25/2024 |
| Medicare PECOS PAC ID | 5799817094 |
|---|---|
| Medicare Enrollment ID | O20100722000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326191156 | NPI | - | NPPES |
| 360010600 | Medicaid | FL | |
| 306725 | Other | FL | WELLCARE |
| 000199000 | Medicaid | FL |
| Provider Name | Venus M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275785255 PECOS PAC ID: 8820152465 Enrollment ID: I20090127000501 |
| Provider Name | Juan D Oms |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508067679 PECOS PAC ID: 2769674795 Enrollment ID: I20101206001231 |
| Provider Name | Gloria Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124128160 PECOS PAC ID: 9830387174 Enrollment ID: I20101230000410 |
| Provider Name | Maria A Rodil |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740384122 PECOS PAC ID: 7214935758 Enrollment ID: I20170120002432 |
| Provider Name | Linda M Collado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588958391 PECOS PAC ID: 7517117591 Enrollment ID: I20170725002952 |
| Provider Name | Janelle N Martindale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932549227 PECOS PAC ID: 0648511121 Enrollment ID: I20190410001106 |
| Provider Name | Denise Haye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144474503 PECOS PAC ID: 7012346604 Enrollment ID: I20200402001013 |
| Provider Name | Adelaida Cueto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780952762 PECOS PAC ID: 0244475234 Enrollment ID: I20201218001975 |
| Provider Name | Kala Markeena Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609248681 PECOS PAC ID: 5698171130 Enrollment ID: I20210908001695 |
| Provider Name | Caitlin Meyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932556776 PECOS PAC ID: 6103104047 Enrollment ID: I20210929002730 |
| Provider Name | Raul Ulloa Valladares |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922574185 PECOS PAC ID: 6507255536 Enrollment ID: I20211113000065 |
| Provider Name | Melissa Garcia-martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942738950 PECOS PAC ID: 0648665935 Enrollment ID: I20220323002862 |
| Provider Name | Roxana Cevallos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760822811 PECOS PAC ID: 9032506746 Enrollment ID: I20220427003168 |
| Provider Name | Roberto Javier Silva Hector |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811470537 PECOS PAC ID: 9739563750 Enrollment ID: I20220825000111 |
| Provider Name | Nikelson Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497480636 PECOS PAC ID: 4981088101 Enrollment ID: I20220907000559 |
| Provider Name | Tiffany Yolanda Hodgson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508578899 PECOS PAC ID: 6901271295 Enrollment ID: I20230419002276 |
| Provider Name | Jesus Williams Tormo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104207307 PECOS PAC ID: 7012360977 Enrollment ID: I20240126001320 |
| Provider Name | Lilibette Acosta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407629926 PECOS PAC ID: 8123471653 Enrollment ID: I20240131002144 |
| Provider Name | Karina V La Banca |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750655742 PECOS PAC ID: 4486007804 Enrollment ID: I20240201000518 |
| Provider Name | Jesus Tarajano |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437938925 PECOS PAC ID: 7517300882 Enrollment ID: I20240205000561 |
| Provider Name | Agostina Lucia Giobio |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1588353155 PECOS PAC ID: 2163865155 Enrollment ID: I20240206004994 |
| Provider Name | Bonnie Kennedy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669706362 PECOS PAC ID: 6901143817 Enrollment ID: I20240213001022 |
| Provider Name | Tianny Cendan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124511548 PECOS PAC ID: 9638513047 Enrollment ID: I20240213004233 |
| Provider Name | Maria O Hernandez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003213703 PECOS PAC ID: 3375987639 Enrollment ID: I20240215000565 |
| Provider Name | Yousy Jimenez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326794777 PECOS PAC ID: 5597109488 Enrollment ID: I20240220000010 |
| Provider Name | Maria W Hernandez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972970085 PECOS PAC ID: 0345686457 Enrollment ID: I20240312001867 |
| Provider Name | Fathiya Hafidh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427816834 PECOS PAC ID: 0446690606 Enrollment ID: I20240504000337 |
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