Provider Demographics
NPI:1801137112
Name:LONDONO, LAURA (PA)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LONDONO
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2300 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3254
Mailing Address - Country:US
Mailing Address - Phone:954-436-8036
Mailing Address - Fax:954-217-5774
Practice Address - Street 1:2300 N COMMERCE PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3254
Practice Address - Country:US
Practice Address - Phone:954-436-8036
Practice Address - Fax:954-217-5774
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2016-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9107013363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant