MRS. JENNIFER MARY BRODERICK PA-C
NPI 1962499723
Physician Assistant - Surgical in St Petersburg, FL
- Individual
- Female
- Physician Assistant
- Surgical
About JENNIFER BRODERICK
This page provides the complete NPI Profile along with additional information for Jennifer Broderick, a provider established in St Petersburg, Florida with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1962499723 assigned on October 2005. The practitioner's primary taxonomy code is 363AS0400X with license number 9102539 (FL). The provider is registered as an individual and her NPI record was last updated 13 years ago.
- NPI
- 1962499723 Verify this NPI
- Provider Name
- MRS. JENNIFER MARY BRODERICK PA-C
- Other Name
- MISS JENNIFER MARY MOON PA-C
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 960 7TH AVE N ST PETERSBURG, FL 33705
- Location Phone
- (727) 821-8101
- Location Fax
- (727) 894-8360
- Mailing Address
- 960 7TH AVE N ST PETERSBURG, FL 33705
- Mailing Phone
- (727) 821-8101
- Mailing Fax
- (727) 894-8360
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-05-2005
- Last Update Date
- 03-29-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 9102539
- License State
- FL
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| U1343A | MEDICARE PIN (08) | FL | |
| 291647900 | MEDICAID (05) | FL | |
| P98242 | MEDICARE UPIN (02) | FL |
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Other Providers at the Same Location
The following 13 providers are registered at the same or a nearby location.
SAINT PETERSBURG, FL 33705
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962499723, enumerated as an "individual" on October 05, 2005.
The provider is located at 960 7TH AVE N ST PETERSBURG, FL 33705 and the phone number is (727) 821-8101.
Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
