Beacon of Life Florida LLC

Primary specialty

PACE Provider OrganizationTaxonomy code 251T00000X

Legal business name

BEACON OF LIFE FLORIDA LLC

Practice address

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

Phone

(855) 801-2653

NPI assigned

Jan 6, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Czermak

Title

Cao

Phone

(855) 801-2653

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1767657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1669339289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 SYNERGY WAY BLDG P",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321172502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 SYNERGY WAY BLDG P",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321172502",
            "telephone_number": "855-801-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON OF LIFE FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-06",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "CZERMAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "855-801-2653"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• PACE Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.