person
Mr. Kevin K Carlisle, PA
Surgical Physician Assistant in Tampa, Florida
NPI 1669467833

Kevin K Carlisle is a Surgical Physician Assistant based in Tampa, FL and is specialized in Surgical. Kevin K Carlisle practices in Tampa, FL and has the professional credentials of PA. The NPI Number for Kevin K Carlisle is 1669467833 and holds a License No. PA1682 (Florida).

The current practice location address for Kevin K Carlisle is 12880 Commodity Pl, Tampa, FL and can be reached out via phone at 813-343-5500 and via fax at 866-462-7445. You can also correspond with Kevin K Carlisle through the mailing address at PO BOX 21686, TAMPA, FL - 33622-1686 (mailing address contact number: 813-343-5500).

Location: 12880 Commodity Pl, Tampa, FL, 33622-1686
person
Provider Profile Details
NPI Number
1669467833
Provider Name
Kevin K Carlisle
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
12880 Commodity Pl, Tampa, FL, 33622-1686
Phone Number
813-343-5500
Fax Number
866-462-7445
Provider Enumeration Date
09/14/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
650420578 01 FL CHAMPUS/TRICARE
X1592 01 FL BLUE CROSS BLUE SHIELD
290188900 05 FL
institution
Provider Business Practice Location Address Details
Address
12880 Commodity Pl
City
State
Zip
33626-3101
Phone Number
813-343-5500
Fax Number
866-462-7445
person
Provider Business Mailing Address Details
Address
12880 Commodity Pl
City
State
Zip
33626-3101
Phone Number
813-343-5500
Fax Number
866-462-7445
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA1682 (Florida)
Definition
Definition to come...
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