Provider Demographics
NPI:1982043311
Name:ZELEKE, EDEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:EDEN
Middle Name:A
Last Name:ZELEKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 PINELLAS ST STE 230
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3809
Mailing Address - Country:US
Mailing Address - Phone:727-462-3401
Mailing Address - Fax:727-533-5994
Practice Address - Street 1:303 PINELLAS ST STE 230
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3809
Practice Address - Country:US
Practice Address - Phone:727-462-3401
Practice Address - Fax:727-533-5994
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN19136207V00000X
FLME132086207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022430700Medicaid