MEDICARE: CARLY CASEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1841129681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY CASEY

Provider Business Mailing Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

Provider Business Practice Location Address
First Line	:	5707 N 22ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4350
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:	813-231-7324

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

Similar Medicare Providers

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Practice Location Address:

507- N22ND STREET
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33610-4350

Practice Phone: 813-239-8069
Practice Fax:

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1750764809 — MRS. JENNIFER K WHEELER ARNP
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1982369450 — OMAR ALI
Practice Location Address:

5707 N 22ND ST
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1346224011 — IBIS HEALTHCARE INC
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1629032073 — STEPHANIE LOCKETT M.D.
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Directions to “ CARLY CASEY ” Practice Location

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