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

Joellen Gordon, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1245356393

Joellen Gordon, PHYSICIANASSISTANT is a Physician Assistant in Tampa, Florida. Qualified in 2014, 12 years ago. Practices with Thriving Lane, a 24-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
12
Licensed in
FL
In the registry since
2007
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Practice location Address checks out

6821 W Hillsborough Ave Ste #19
Tampa, FL 33634-5003
Phone: (813) 890-0705
Fax: (813) 890-0710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA 2812 (FL)

Record details

NPI number1245356393
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedMarch 21, 2007
Last updated in NPPESApril 6, 2016

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Thriving Lane — 24 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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