Provider Demographics
NPI:1053533497
Name:LONGO, CHRISTINE MARIE (LMT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:LONGO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
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Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8901
Practice Address - Street 1:280 FARNER PL
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-6066
Practice Address - Country:US
Practice Address - Phone:352-674-1710
Practice Address - Fax:352-674-8910
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2021-11-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily