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General NPI Number Information
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NPI Number | 1154586972
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Entity Type | Individual
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Provider Name | MARILYN LLAVONA-SUAREZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 10621 WITTENBERG WAY
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City | ORLANDO
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State | FL
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Zip | 32832-7028
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Country | US
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Telephone | 407-994-4606
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Fax | 888-338-4430
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Provider Business Mailing Address
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Address Line | 10621 WITTENBERG WAY
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City | ORLANDO
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State | FL
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Zip | 32832-7028
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Country | US
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Telephone | 407-994-4606
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Fax | 888-338-4430
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 17207
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1093
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License Number State | FL
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