Provider Demographics
NPI:1427710797
Name:SEDON, LESLIE D (RDN)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:D
Last Name:SEDON
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 W COPELAND DR FL 1
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2002
Mailing Address - Country:US
Mailing Address - Phone:321-843-8900
Mailing Address - Fax:321-843-8916
Practice Address - Street 1:89 W COPELAND DR FL 1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2002
Practice Address - Country:US
Practice Address - Phone:321-843-8900
Practice Address - Fax:321-843-8916
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-13
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND10781133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered