Healthcare Provider Details

I. General information

NPI: 1275400608
Provider Name (Legal Business Name): HEALING PATH HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15260 SW 280TH ST STE 116
HOMESTEAD FL
33032-8186
US

IV. Provider business mailing address

15260 SW 280TH ST STE 116
HOMESTEAD FL
33032-8186
US

V. Phone/Fax

Practice location:
  • Phone: 305-998-7885
  • Fax: 877-811-0032
Mailing address:
  • Phone: 305-998-7885
  • Fax: 877-811-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL A REGO
Title or Position: OFFICER
Credential:
Phone: 786-972-7393