Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Jennifer Mary Broderick, PA-C

Individual provider Surgical Physician Assistant · NPI 1962499723

Mrs. Jennifer Mary Broderick, PA-C is a Surgical Physician Assistant in St Petersburg, Florida. Licensed in Florida. Registered with an NPI since 2005.

Licensed in
FL
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

960 7th Ave N
St Petersburg, FL 33705-1347
Phone: (727) 821-8101
Fax: (727) 894-8360
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 9102539 (FL)

Record details

NPI number1962499723
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 5, 2005
Last updated in NPPESMarch 29, 2013

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