Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Longevity Clinical Ltc Associates of Georgia, PC

Organization Family Medicine Physician · NPI 1699469668

Longevity Clinical Ltc Associates of Georgia, PC is a Family Medicine Physician in Atlanta, Georgia. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
4
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1040 Crown Pointe Pkwy Ste 600
Atlanta, GA 30338-4741
Phone: (561) 815-2427
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Geriatric Medicine (Family Medicine) Physician Taxonomy 207QG0300X
Gerontology Nurse Practitioner Taxonomy 363LG0600X
Primary Care Nurse Practitioner Taxonomy 363LP2300X

Record details

NPI number1699469668
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Vincur — Lwc Practice Manager · (561) 815-2427
NPI enumeratedJune 5, 2023
Last updated in NPPESJune 5, 2023
Certification dateJune 5, 2023
Mailing address11780 Us Highway 1 Ste N107, North Palm Beach, FL 33408-3007

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