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BEACON OF LIFE FLORIDA LLC
NPI 1669339289
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization in Holly Hill, FL

Active since January 06, 2026CLIA 10D2340360 · Waiver
1200 SYNERGY WAY BLDG P, HOLLY HILL, FL 32117(855) 801-2653 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Beacon Of Life Florida Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACON OF LIFE FLORIDA LLC (NPI 1669339289) is a healthcare organization registered as a program of all-inclusive care for the elderly (pace) provider organization in Holly Hill, Florida and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through March 16, 2028 and lists Michael Czermak, Cao, as its authorized official.

NPPES Registry Identity

NPI1669339289
Entity TypeOrganization
Primary Taxonomy251T00000X
Legal Business NameBEACON OF LIFE FLORIDA LLC
Location Address1200 SYNERGY WAY BLDG PHolly Hill, FL 32117-2502
Mailing Address1200 Synergy Way Bldg PHolly Hill, FL 32117-2502
Phone(855) 801-2653
Organization SubpartNo
Authorized OfficialMichael CzermakCao · (855) 801-2653
Enumeration DateJanuary 6, 2026
NPPES CertifiedJanuary 6, 2026
✔ NPI 1669339289 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProgram of All-Inclusive Care for the Elderly (PACE) Provider OrganizationAgencies
Taxonomy Code251T00000X
Definition
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.
1200 SYNERGY WAY BLDG P, Holly Hill, FL 32117
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2340360

Beacon Of Life Florida, LLC · Holly Hill, FL
Active · expires Mar 16, 2028
CLIA Number10D2340360
Laboratory TypePace Clinic
Certificate Effective DateMarch 17, 2026
Certificate Expiration DateMarch 16, 2028
Laboratory DirectorBrian Fornadel
Laboratory Phone(407) 402-6815
Laboratory LocationBeacon Of Life Florida, LLC1200 Synergy Way Building P, Holly Hill, FL 32117
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beacon Of Life Florida LLC's NPI number?

The NPI number for Beacon Of Life Florida LLC is 1669339289. It was assigned to this organization in the NPPES registry on January 6, 2026.

Where is Beacon Of Life Florida LLC located?

Beacon Of Life Florida LLC is located at 1200 Synergy Way Bldg P, Holly Hill, FL 32117. The listed phone number is (855) 801-2653.

What is Beacon Of Life Florida LLC's specialty?

The primary specialty registered for this NPI is Program of All-Inclusive Care for the Elderly (PACE) Provider Organization with taxonomy code 251T00000X.

Does Beacon Of Life Florida LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2340360) is associated with this NPI, valid through March 16, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Beacon Of Life Florida LLC was last updated on January 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.