Individual
EILEEN LUONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
8300 SW 44TH CT, DAVIE, FL 33328-2993
(954) 560-5238
Mailing address
8300 SW 44TH CT, DAVIE, FL 33328-2993
(954) 560-5238
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN2068892
FL
163WC0400X
Case Management Registered Nurse
RN2068892
FL
163WC1500X
Community Health Registered Nurse
RN2068892
FL
163WC1600X
Continuing Education/Staff Development Registered Nurse
RN2068892
FL
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN2068892
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN2068892
STATE LICENSE
FL
Enumeration date
11/13/2018
Last updated
11/13/2018
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