Provider Demographics
NPI:1174001655
Name:LIVING LIGHT LLC
Entity Type:Organization
Organization Name:LIVING LIGHT LLC
Other - Org Name:SOPHIE'S ANGEL CARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FIDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARROZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-693-7989
Mailing Address - Street 1:4851 TAMIAMI TRL N STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-3098
Mailing Address - Country:US
Mailing Address - Phone:239-302-1632
Mailing Address - Fax:813-803-3389
Practice Address - Street 1:4851 TAMIAMI TRL N STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3098
Practice Address - Country:US
Practice Address - Phone:239-302-1632
Practice Address - Fax:813-803-3389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-06
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care