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

Tyler Theodore Otto

Individual provider Family Medicine Physician · NPI 1639667314

Tyler Theodore Otto is a Family Practice in Largo, Florida. Qualified in 2018, 8 years ago. Practices with Suncoast Family Medical Associates, a 14-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
8
Licensed in
FL
In the registry since
2018

Practice location Address checks out

12020 Seminole Blvd
Largo, FL 33778-2805
Phone: (727) 588-9572
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 17987 (FL)

Record details

NPI number1639667314
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 27, 2018
Last updated in NPPESJuly 15, 2021
Certification dateJuly 15, 2021
Mailing address12020 Seminole Blvd, Largo, FL 33778-2805

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Suncoast Family Medical Associates — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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