Provider Demographics
NPI:1346276482
Name:ABELEDA, JOSELITA M (MD)
Entity Type:Individual
Prefix:MS
First Name:JOSELITA
Middle Name:M
Last Name:ABELEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1205 F AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:AZ
Mailing Address - Zip Code:85607-1920
Mailing Address - Country:US
Mailing Address - Phone:520-364-1429
Mailing Address - Fax:520-364-4261
Practice Address - Street 1:1590 PASEO SAN LUIS
Practice Address - Street 2:STE 102
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:16354-1655
Practice Address - Country:US
Practice Address - Phone:520-459-0203
Practice Address - Fax:520-364-4261
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD061706L208000000X
AZ46132208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001654493Medicaid
AZ743875Medicaid
PA001654493Medicaid
AZ1346276482Medicare PIN