Provider Demographics
NPI:1235423120
Name:JEANNE-ELYSE CEDENO M.D., P.A.
Entity Type:Organization
Organization Name:JEANNE-ELYSE CEDENO M.D., P.A.
Other - Org Name:THE FAMILY DOCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JEANNE-ELYSE
Authorized Official - Middle Name:GRAY
Authorized Official - Last Name:CEDENO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:754-273-6278
Mailing Address - Street 1:10041 PINES BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6170
Mailing Address - Country:US
Mailing Address - Phone:754-273-6278
Mailing Address - Fax:954-374-6954
Practice Address - Street 1:10041 PINES BLVD STE A
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6170
Practice Address - Country:US
Practice Address - Phone:754-273-6278
Practice Address - Fax:954-374-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 106978207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty