Provider Demographics
NPI:1447458880
Name:SAUDER, DEBORAH J (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:J
Last Name:SAUDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11505 RANGELAND PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4041
Mailing Address - Country:US
Mailing Address - Phone:941-907-6016
Mailing Address - Fax:941-907-0199
Practice Address - Street 1:11505 RANGELAND PKWY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4041
Practice Address - Country:US
Practice Address - Phone:941-907-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN8344207Q00000X
FLME99412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL336228OtherAMERIGROUP
FL14419OtherUNITED HEALTHCARE
FL2811375-00Medicaid
FL336228OtherAMERIGROUP