Provider Demographics
NPI:1386536035
Name:DR. SUSANA LONDONO, LLC
Entity type:Organization
Organization Name:DR. SUSANA LONDONO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONDONO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-304-5373
Mailing Address - Street 1:601 CLEVELAND ST STE 501-12
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33755-4172
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:727-655-9622
Practice Address - Street 1:601 CLEVELAND ST STE 501-12
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33755-4172
Practice Address - Country:US
Practice Address - Phone:727-304-5373
Practice Address - Fax:727-655-9622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty