Organization Active NPI

Gedeon Medical Center, MD

  • Primary Care Clinic/Center
  • Hollywood, FL
National Provider Identifier
1922753516
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
GEDEON MEDICAL CENTER, MD
Practice address
11011 Sheridan St Ste 215
Hollywood, FL 33026-1531
Phone
(954) 842-4285
NPI assigned
Feb 13, 2022
Last updated
Feb 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Leon Gedeon, MDNPI 1962727917
Title
President
Phone
(954) 842-4285

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

11011 Sheridan St Ste 215
Hollywood, FL 33026-1531

Mailing address

11011 Sheridan St Ste 215
Hollywood, FL 33026-1531
Phone (954) 842-4285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220809003371 FL Part B Supplier - Clinic/Group Practice 3072995950 Receives reassigned benefits from 1 practitioner
Practice locations: Hollywood, FL

National Provider Directory

National Provider Directory

Locations

11011 Sheridan St
Ste 215
Hollywood, FL 33026
Phone (954) 447-0606

2450 Hollywood Blvd
Ste 104
Hollywood, FL 33020

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1922753516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST STE 215",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261531",
            "telephone_number": "954-842-4285",
            "fax_number": "954-671-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST STE 215",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261531",
            "telephone_number": "954-842-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEDEON MEDICAL CENTER, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-13",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "GEDEON",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-842-4285",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.