Healthcare Provider Details

I. General information

NPI: 1467269936
Provider Name (Legal Business Name): PEACEFUL PATH CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2024
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W 84TH ST STE 111A
HIALEAH FL
33016-5771
US

IV. Provider business mailing address

2300 W 84TH ST STE 111A
HIALEAH FL
33016-5771
US

V. Phone/Fax

Practice location:
  • Phone: 305-530-8103
  • Fax: 305-530-8351
Mailing address:
  • Phone: 305-530-8103
  • Fax: 305-530-8351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NIVIA PEREZ VALCARCEL
Title or Position: OWNER
Credential:
Phone: 305-530-8103