MEDICARE: DR. CAROLINA LONDONO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN22791	FL

General Provider Information

NPI Number	:	1700307303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLINA LONDONO DMD

Provider Business Mailing Address
First Line	:	1737 6TH ST NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-2301
Country	:	US
Telephone Number	:	863-508-2565
Fax Number	:

Provider Business Practice Location Address
First Line	:	1737 6TH ST NW
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33881-2301
Country	:	US
Telephone Number	:	863-508-2565
Fax Number	:	863-508-2566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2017
Last Update Date	:	08/13/2025

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