Provider Demographics
NPI:1295983054
Name:LONDONO, DIEGO
Entity type:Individual
Prefix:
First Name:DIEGO
Middle Name:
Last Name:LONDONO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 LAKESIDE RESERVE LANE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810
Mailing Address - Country:US
Mailing Address - Phone:407-292-3239
Mailing Address - Fax:
Practice Address - Street 1:8751 COMMODITY CIR
Practice Address - Street 2:SUITE 7
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9027
Practice Address - Country:US
Practice Address - Phone:407-226-3733
Practice Address - Fax:407-226-3734
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2009-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health