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General NPI Number Information
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NPI Number | 1861286890
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Entity Type | Organization
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Legal Business Name | LONDON COLLECTIVE LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 16506 POINTE VILLAGE DR STE 207
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City | LUTZ
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State | FL
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Zip | 33558-5254
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Country | US
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Telephone | 813-954-2220
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Fax |
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Provider Business Mailing Address
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Address Line | 8915 FORGE BREEZE LOOP
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-2331
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Country | US
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Telephone | 813-954-2220
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | DANIELA LONDONO
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Credential | DNP
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Telephone | 813-954-2220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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