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

Tanner Wilson

Individual provider Anesthesiology Physician · NPI 1134906753

Tanner Wilson is an Anesthesiology Assistant in Tampa, Florida. Qualified in 2023, 3 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
3
Licensed in
FL
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

12902 Usf Magnolia Dr
Tampa, FL 33612-9416
Phone: (888) 663-3488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence AA831 (FL)
Anesthesiology Physician Taxonomy 207L00000X · Licence AA831 (FL)

Record details

NPI number1134906753
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 8, 2023
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025
Mailing addressPo Box 198441, Atlanta, GA 30384-8441

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 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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