Healthcare Provider Details

I. General information

NPI: 1134049935
Provider Name (Legal Business Name): PEACE HOME HEALTH CARE CENTER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 W 16TH AVE STE 309A
HIALEAH FL
33012-7139
US

IV. Provider business mailing address

4445 W 16TH AVE STE 309A
HIALEAH FL
33012-7139
US

V. Phone/Fax

Practice location:
  • Phone: 786-949-6989
  • Fax:
Mailing address:
  • Phone: 786-949-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIA DE LA TEJA
Title or Position: OWNER, CFO
Credential:
Phone: 786-949-6989