Healthcare Provider Details

I. General information

NPI: 1245648500
Provider Name (Legal Business Name): LIGHT OF LIFE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10967 LAKE UNDERHILL RD SUITE 112
ORLANDO FL
32825-4457
US

IV. Provider business mailing address

10967 LAKE UNDERHILL RD SUITE 112
ORLANDO FL
32825-4457
US

V. Phone/Fax

Practice location:
  • Phone: 407-568-8704
  • Fax: 407-674-6808
Mailing address:
  • Phone: 407-568-8704
  • Fax: 407-674-6808

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

VIII. Authorized Official

Name: MS. GISELA RAMOS
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 407-568-8704