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

Monte Revell Willis

Individual provider Physician Assistant · NPI 1780425892

Monte Revell Willis is a Physician Assistant in Panama City, Florida. Qualified in 2024, 2 years ago. Practices with Dermatology Associates of Tallahassee PA, a 39-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
2
In the registry since
2024

Practice location Address checks out

425 W 19th St Ste D&e
Panama City, FL 32405-4659
Phone: (850) 818-0220
Fax: (850) 818-0156
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1704 Riggins Rd, Tallahassee, FL 32308-5318 — (850) 877-4134

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1780425892
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 3, 2024
Last updated in NPPESMay 27, 2026
Certification dateMay 27, 2026
Mailing addressPo Box 13834, Tallahassee, FL 32317-3834

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 Dermatology Associates Of Tallahassee Pa — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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