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

Chheng Ly

Individual provider Physician Assistant · NPI 1235738204

Chheng Ly is a Physician Assistant in Bradenton, Florida. Qualified in 2020, 6 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group and works from 2 locations. Licensed in California and Florida.

Years since qualifying
6
Licensed in
CA, FL
In the registry since
2020
Specialties on file
2
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Practice location Address checks out

5309 E State Road 64
Bradenton, FL 34208-5534
Phone: (941) 747-9818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1901 Floyd St, Sarasota, FL 34239-2932 — (941) 366-9222

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9115734 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 58645 (CA)

Record details

NPI number1235738204
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 21, 2020
Last updated in NPPESJanuary 20, 2023
Certification dateJanuary 20, 2023
Mailing address101 Riverfront Blvd Ste 710, Bradenton, FL 34205-8812

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice H Lee Moffitt Cancer Ctr And Res Inst Life Time Cancer Scrn Ctr Inc — 1135 clinicians
Accepts Medicare assignment Not indicated

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