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

Gabrielle Keovongsa

Individual provider Physician Assistant · NPI 1841083896

Gabrielle Keovongsa is a Physician Assistant in Tampa, Florida. Qualified in 2025, 1 year ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
1
Licensed in
FL
In the registry since
2025
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Practice location Address checks out

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (813) 745-4673
Fax: (813) 449-8618
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1600 Sw Archer Rd, Gainesville, FL 32610-3003 — (352) 273-7832

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9120480 (FL)

Record details

NPI number1841083896
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 23, 2025
Last updated in NPPESJanuary 23, 2026
Certification dateJanuary 23, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 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

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