Jessica Deklavon

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115460 Issued in FL

Practice address

1150 N 35TH Ave Ste 130
Hollywood, FL 33021-5424

Phone

(954) 265-7700

Fax

(954) 276-0021

NPI assigned

Mar 22, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Regional Hospital Hospital, Hollywood, FL, CCN 100038

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• South Broward Hospital District

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Hollywood, FL
  • NPI 1174942783
  Medicare reassignment Care Compare group NPD
• South Broward Hospital District

  • Home Infusion Therapy Pharmacy
  • Miramar, FL
  • NPI 1043656614
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Broward Hospital District

  • General Acute Care Hospital
  • Hollywood, FL
  • NPI 1780667923
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1407505779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N 35TH AVE STE 130",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215424",
            "telephone_number": "954-265-7700",
            "fax_number": "954-276-0021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1951 SW 172nd Ave Ste 405",
            "address_purpose": "LOCATION",
            "city": "Miramar",
            "state": "FL",
            "postal_code": "330295614",
            "country_code": "US",
            "telephone_number": "954-265-7700",
            "fax_number": "954-276-0021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEKLAVON",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-22",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "PA9115460",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jdeklavon310042@mhsdirect.net",
            "affiliation": "N",
            "endpointDescription": "jdeklavon310042@mhsdirect.net",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1150 N 35th Ave",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kristina Deeter, M.D.
• Suzanne Elise Defrank, OTA
• Michelle M Defreitas, M.D.
• Timothy Degan, DO
• Yves Dehaut
• Xenia Marie Del Pozo, CRNA
• Greter Del Valle Gonzalez, PHARM.D.
• Janell Fernanda Del Valle
• Delcin Health Center
• Nadege Delcin-Garcon, ARNP

• Physician Assistant in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.