Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jessica Deklavon

Individual provider Physician Assistant · NPI 1407505779

Jessica Deklavon is a Physician Assistant in Hollywood, Florida. Qualified in 2021, 5 years ago. Practices with South Broward Hospital District, a 665-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
5
Licensed in
FL
In the registry since
2022
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Practice location Address checks out

1150 N 35th Ave Ste 130
Hollywood, FL 33021-5424
Phone: (954) 265-7700
Fax: (954) 276-0021
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1951 Sw 172nd Ave Ste 405, Miramar, FL 33029-5614 — (954) 265-7700

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9115460 (FL)

Record details

NPI number1407505779
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 22, 2022
Last updated in NPPESApril 27, 2026
Certification dateApril 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice South Broward Hospital District — 665 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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