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

Joellen Gordon, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1245356393

Joellen Gordon, PHYSICIANASSISTANT is a Physician Assistant in Tampa, Florida. Qualified in 2014, 12 years ago. Practices with Thriving Lane, a 24-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
12
Licensed in
FL
In the registry since
2007
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Practice location Address checks out

6821 W Hillsborough Ave Ste #19
Tampa, FL 33634-5003
Phone: (813) 890-0705
Fax: (813) 890-0710
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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 PA 2812 (FL)

Record details

NPI number1245356393
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedMarch 21, 2007
Last updated in NPPESApril 6, 2016
Mailing address2810 W Dr Mlk Blvd, Tampa, FL 33607-6306

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Thriving Lane — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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