# THE LONGEVITY SOCIETY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902718661
- **Authorized official:** NANCY N FONG-EDWARDS APRN (CEO)
- **Authorized official phone:** (786) 443-2629

## Contact information

- **Practice address:** 150 NW 70TH AVE STE 7, PLANTATION, FL 33317-2911
- **Practice address phone:** (954) 494-8799
- **Mailing address:** 2633 OAK PARK CIR, DAVIE, FL 33328-6724
- **Mailing address phone:** (786) 443-2629

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2026
- **Last updated:** 09/18/2026