Provider Demographics
NPI:1841698800
Name:LONDON, CARYN
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:LONDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9851 NW 20TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5839
Mailing Address - Country:US
Mailing Address - Phone:954-540-5662
Mailing Address - Fax:954-977-4244
Practice Address - Street 1:9851 NW 20TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071
Practice Address - Country:US
Practice Address - Phone:954-540-5662
Practice Address - Fax:954-977-4244
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-08
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist