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

Justina Lena Jacqueline Brantley

Individual provider Physician Assistant · NPI 1528719168

Justina Lena Jacqueline Brantley is a Physician Assistant in Tampa, Florida. Qualified in 2024, 2 years ago. Practices with H Lee Moffitt Cancer Ctr and Res Inst Life Time Cancer Scrn Ctr Inc, a 1,135-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2022
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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.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9118933 (FL)

Record details

NPI number1528719168
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 14, 2022
Last updated in NPPESSeptember 30, 2025
Certification dateSeptember 30, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 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 locations2 on file with Medicare

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