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

Lavarous Antwon Johnson, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1073273660

Lavarous Antwon Johnson, PHYSICIANASSISTANT is a Physician Assistant in Tampa, Florida. Qualified in 2021, 5 years ago. Practices with Tampa Family Health Centers Inc, a 64-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
5
In the registry since
2021
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Practice location Address checks out

401 W Kennedy Blvd
Tampa, FL 33606-1450
Phone: (757) 528-7563
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6223 66th St N, Pinellas Park, FL 33781-5025 — (727) 528-4900

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1073273660
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedDecember 22, 2021
Last updated in NPPESMay 25, 2023
Certification dateMay 25, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Tampa Family Health Centers Inc — 64 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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