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

Carly Tanner, PA

Individual provider Physician Assistant · NPI 1033416565

Carly Tanner, PA is a Physician Assistant in Tampa, Florida. Qualified in 2010, 16 years ago. Practices with Leavitt Medical Associates of Florida Inc, a 195-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
16
Licensed in
FL
In the registry since
2011
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

2835 W De Leon St Ste 103
Tampa, FL 33609-4130
Phone: (813) 875-7333
Fax: (813) 875-8833
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9105781 (FL)

Record details

NPI number1033416565
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedFebruary 18, 2011
Last updated in NPPESJuly 9, 2019
Mailing address151 Southhall Ln, Ste 300, Maitland, FL 32751-7176

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Leavitt Medical Associates Of Florida Inc — 195 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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