Provider Demographics
NPI:1699703884
Name:LONDONO, ANN I (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:I
Last Name:LONDONO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:BOX 016960 M851
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33101-6960
Mailing Address - Country:US
Mailing Address - Phone:305-243-4029
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:BOX 016960 M851
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33101-6960
Practice Address - Country:US
Practice Address - Phone:305-243-4029
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME849902080P0006X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2642662-00Medicaid
FLI24037Medicare UPIN