Healthcare Provider Details

I. General information

NPI: 1689308363
Provider Name (Legal Business Name): MONICA LONDONO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2022
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 OCEAN DR STE 8
BOYNTON BEACH FL
33426-5131
US

IV. Provider business mailing address

3580 LAKE WORTH RD
PALM SPRINGS FL
33461-4029
US

V. Phone/Fax

Practice location:
  • Phone: 561-737-4777
  • Fax:
Mailing address:
  • Phone: 561-425-5075
  • Fax: 561-360-3467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number11020648
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: