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General NPI Number Information
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NPI Number | 1184867202
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Entity Type | Individual
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Provider Name | JEANNE-ELYSE GRAY CEDENO M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 127 SANDOVAL RD SW
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City | LOS LUNAS
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State | NM
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Zip | 87031-7320
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Country | US
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Telephone | 505-865-3373
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Fax |
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Provider Business Mailing Address
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Address Line | 10041 PINES BLVD STE A
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6170
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Country | US
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Telephone | 754-273-6278
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Fax | 954-374-6954
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | BP10030078
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 79257
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME 106978
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2025-0655
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License Number State | NM
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