Individual
DR. JEANNE-ELYSE GRAY CEDENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
127 SANDOVAL RD SW, LOS LUNAS, NM 87031-7320
(505) 865-3373
Mailing address
10041 PINES BLVD STE A, PEMBROKE PINES, FL 33024-6170
(754) 273-6278
(954) 374-6954
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
79257
CT
207Q00000X
Family Medicine Physician
BP10030078
TX
207Q00000X
Family Medicine Physician
Primary
MD2025-0655
NM
207Q00000X
Family Medicine Physician
ME 106978
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004106900
—
FL
01
—
12239368
CAQH
—
01
—
79257
MEDICAL LICENSE
CT
Enumeration date
04/20/2009
Last updated
08/11/2025
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