Provider Demographics
NPI:1154586972
Name:LLAVONA-SUAREZ, MARILYN (MD)
Entity type:Individual
Prefix:DR
First Name:MARILYN
Middle Name:
Last Name:LLAVONA-SUAREZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARILYN
Other - Middle Name:
Other - Last Name:LLAVONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:10621 WITTENBERG WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7028
Mailing Address - Country:US
Mailing Address - Phone:407-994-4606
Mailing Address - Fax:888-338-4430
Practice Address - Street 1:10621 WITTENBERG WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7028
Practice Address - Country:US
Practice Address - Phone:407-994-4606
Practice Address - Fax:888-338-4430
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17207208D00000X
FLACN1093208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice