Beacon of Life Florida LLC · PACE Provider Organization

1200 Synergy Way Bldg P, Holly Hill, FL 32117-2502

Overview

Beacon of Life Florida LLC is a PACE Provider Organization (organization) practicing in Holly Hill, Florida. The National Provider Identifier (NPI) is #1669339289, which was assigned on January 6, 2026, and the registration record was last updated on January 6, 2026. The practitioner's main practice location is at 1200 Synergy Way Bldg P, Holly Hill, FL 32117-2502; the contact telephone number is 8558012653. The primary taxonomy of Beacon of Life Florida LLC is PACE Provider Organization (251T00000X). The authorized official for Beacon of Life Florida LLC is Michael Czermak (Cao).

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.

Provider Information

NPI 1669339289
Entity Type Organization
Organization Name BEACON OF LIFE FLORIDA LLC
Provider Name BEACON OF LIFE FLORIDA LLC
Practice Address 1200 Synergy Way Bldg P
Holly Hill
FL 32117-2502
Practice Telephone 8558012653
Mailing Address 1200 Synergy Way Bldg P
Holly Hill
FL 32117-2502
Certification Date 2026-01-06
Enumeration Date 2026-01-06
Last Update Date 2026-01-06
Is Organization Subpart N

Authorized Official Information

Official Name MICHAEL CZERMAK
Official Title CAO
Telephone 8558012653

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y251T00000XProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization

Taxonomy Information

Primary Taxonomy

Code 251T00000X
Taxonomy PACE Provider Organization
Classification Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
Grouping Agencies
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.
Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new]

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Lavashia Jackson 2636 N 12th St, Ocean Springs, MS 39564-9481PACE Provider Organization2025-12-18
Habitat Health San Leandro, LLC 2420 Merced Street, San Leandro, CA 94577PACE Provider Organization2026-01-22
Alliance Home Care Professionals LLC 1403 Carroll White Dr, Indianapolis, IN 46219-3911PACE Provider Organization2025-12-02
Pacificsource Pace, LLC 555 International Way Ste B104, Springfield, OR 97477-6013PACE Provider Organization2026-01-05
Milwaukee Catholic Home, Inc. 2457 Browns Lake Dr, Burlington, WI 53105-7113PACE Provider Organization2025-10-13
Hillsborough Pace LLC 9912 Little Rd, New Port Richey, FL 34654-3419PACE Provider Organization2026-01-06
San Diego Pace, LLC 601 E 14th St Ste 101, National City, CA 91950-4629PACE Provider Organization2025-11-19
Allycia D Lawrence 2208 Paula Cir, Ocean Springs, MS 39564-5672PACE Provider Organization2025-12-18
Innovage California Pace - Los Angeles, LLC 12130 Paramount Blvd, Downey, CA 90242-2339PACE Provider Organization2026-01-16
Milwaukee Catholic Home, Inc. 3995 S 92nd St, Greenfield, WI 53228-2100PACE Provider Organization2025-10-13
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Location Information

Street Address 1200 SYNERGY WAY BLDG P
City HOLLY HILL
State FL
Zip Code 32117-2502
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Shauntria Cherry 1967 Charleston House Way Apt 2204, Holly Hill, FL 32117-2583Behavior Technician2023-01-12
Kausar Parveen 2381 Mason Ave Ste 100, Daytona Beach, FL 32117Internal Medicine Physician2005-10-20
Walgreen Co 1829 Ridgewood Ave, Holly Hill, FL 32117-1737Community/Retail Pharmacy2006-07-29
Dispatchhealth-Florida Inc. 1440 N Nova Rd Ste 305, Daytona Beach, FL 32117-3245Emergency Medicine Physician2021-08-17
Pamela N Williams 1016 Cadillac Dr, Daytona Beach, FL 32117-3959Licensed Practical Nurse2025-08-18
Georges Simple Solutions Inc 1615 Ridgewood Ave Ste 102, Holly Hill, FL 32117-1749Developmental Disabilities Clinic/Center2021-02-04
Tashena Beckford-Ng 1963 Charleston House Way Apt 4306, Holly Hill, FL 32117-2588Home Health Agency2026-02-03
Georges Simple Solutions Inc 1615 Ridgewood Ave Ste 102, Holly Hill, FL 32117-1749Attendant Care Provider2024-01-02
Henri Habib Nammour 2381 Mason Ave Suite 100, Daytona Beach, FL 32117Internal Medicine Physician2006-08-31
Wal-Mart Stores East Lp 1905 N Nova Rd, Daytona Beach, FL 32117-1421Durable Medical Equipment & Medical Supplies2006-08-10
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Similar Providers

Providers with similar names

Provider NameAddressTaxonomyEnumeration Date
Beacon of Wellness, LLC 8401 Mayland Dr # 6186, Richmond, VA 23294-4648Case Manager/Care Coordinator2025-06-20
The Beacon Clinic LLC 600 Wyndhurst Ave Ste 245c, Baltimore, MD 21210-2436Speech-Language Pathologist2024-05-28
Beacon Wellness LLC 4205 State St Ste 5, Bismarck, ND 58503-0623Mental Health Clinic/Center (Including Community Mental Health Center)2020-10-08
Florida Life Rehab Pt Pa 2252 Twelve Oaks Way Ste 102, Wesley Chapel, FL 33544-6972Physical Therapist2023-08-28
Beacon of Peace LLC 1218 W Ocean View Ave Apt D, Norfolk, VA 23503-1147Mental Health Clinic/Center (Including Community Mental Health Center)2025-11-04
Beacon Pathways 18008 Sky Park Cir Ste 140, Irvine, CA 92614-6434Professional Counselor2025-08-01
Beacon Homecare LLC 21006 Devonshire St Ste 209, Chatsworth, CA 91311-8271In Home Supportive Care Agency2025-07-29
Phs Beacon Hill, Inc 5300 Beacon Hill Rd, Minnetonka, MN 55345-5859Assisted Living Facility2014-02-14
Beacon Associates 5161 Nw 102nd Ct, Doral, FL 33178-3200Mental Health Counselor2007-03-22
Beacon Pediatrics LLC 18947 John J Williams Hwy, Suite 212, Rehoboth Beach, DE 19971-4474Pediatric Nurse Practitioner2011-10-11

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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.