Provider Demographics
NPI:1700307303
Name:LONDONO, CAROLINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:
Last Name:LONDONO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 SHALISA BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-9667
Mailing Address - Country:US
Mailing Address - Phone:407-721-6825
Mailing Address - Fax:
Practice Address - Street 1:2909 JAMES L REDMAN PKWY
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-9404
Practice Address - Country:US
Practice Address - Phone:813-426-3475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22791122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist