Provider Demographics
NPI:1265571293
Name:ZELEDON, JORGE IVAN (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:IVAN
Last Name:ZELEDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 N HIGHWAY 27 STE C3
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1000
Mailing Address - Country:US
Mailing Address - Phone:863-314-0880
Mailing Address - Fax:863-837-4475
Practice Address - Street 1:6801 N HIGHWAY 27 STE C3
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1000
Practice Address - Country:US
Practice Address - Phone:863-314-0880
Practice Address - Fax:863-837-4475
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103963207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL145AXOtherBCBS
FL145AXOtherBCBS