Provider Demographics
NPI:1245648500
Name:LIGHT OF LIFE, INC.
Entity type:Organization
Organization Name:LIGHT OF LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-568-8704
Mailing Address - Street 1:10967 LAKE UNDERHILL RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4457
Mailing Address - Country:US
Mailing Address - Phone:407-568-8704
Mailing Address - Fax:407-674-6808
Practice Address - Street 1:10967 LAKE UNDERHILL RD
Practice Address - Street 2:SUITE 112
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4457
Practice Address - Country:US
Practice Address - Phone:407-568-8704
Practice Address - Fax:407-674-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-30
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002147500Medicaid