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

Ayesha Falak Kietzman, PA

Individual provider Physician Assistant · NPI 1336703461

Ayesha Falak Kietzman, PA is a Physician Assistant in Hudson, Florida. Qualified in 2016, 10 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
10
Licensed in
FL
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

13944 Lakeshore Blvd Ste C
Hudson, FL 34667-1431
Phone: (727) 605-0252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 14806 Morning Dr, Lutz, FL 33559-3270 — (850) 559-4257
  • 12902 Usf Magnolia Dr, Tampa, FL 33612-9416 — (813) 745-7365

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9112195 (FL)

Record details

NPI number1336703461
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedApril 24, 2019
Last updated in NPPESJanuary 9, 2026
Certification dateJanuary 9, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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