Healthcare Provider Details

I. General information

NPI: 1922753516
Provider Name (Legal Business Name): GEDEON MEDICAL CENTER, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2022
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 SHERIDAN ST STE 215
HOLLYWOOD FL
33026-1531
US

IV. Provider business mailing address

11011 SHERIDAN ST STE 215
HOLLYWOOD FL
33026-1531
US

V. Phone/Fax

Practice location:
  • Phone: 954-842-4285
  • Fax:
Mailing address:
  • Phone: 954-842-4285
  • Fax: 954-671-0215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LEON GEDEON
Title or Position: PRESIDENT
Credential: MD
Phone: 954-842-4285