Healthcare Provider Details

I. General information

NPI: 1396608337
Provider Name (Legal Business Name): LIGHT OF ONE'S LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4531 WHITE BAY CIR
WESLEY CHAPEL FL
33545-5056
US

IV. Provider business mailing address

4531 WHITE BAY CIR
WESLEY CHAPEL FL
33545-5056
US

V. Phone/Fax

Practice location:
  • Phone: 813-702-9460
  • Fax:
Mailing address:
  • Phone: 813-702-9460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: BRANDY COLBERT
Title or Position: OWNER
Credential:
Phone: 813-479-8398