Healthcare Provider Details

I. General information

NPI: 1053848887
Provider Name (Legal Business Name): JESSICA SAUNDERS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA BOSTIC

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 N 35TH AVE STE 330
HOLLYWOOD FL
33021-5403
US

IV. Provider business mailing address

2900 CORPORATE WAY
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-6333
  • Fax: 954-265-6336
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberME161721
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: