Healthcare Provider Details
I. General information
NPI: 1538078498
Provider Name (Legal Business Name): KELLY SAUNDERS CCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1210 S OLD DIXIE HWY
JUPITER FL
33458-7205
US
IV. Provider business mailing address
9869 WOODWORTH CT
WELLINGTON FL
33414-6409
US
V. Phone/Fax
- Phone: 561-263-2234
- Fax:
- Phone: 781-835-5338
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 242T00000X |
| Taxonomy | Perfusionist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: