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NPI Code Detail

MEDICARE: KAYLA CHRISTINE LONG PA-C

MEDICARE: KAYLA CHRISTINE LONG PA-C
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
1363A00000XPhysician AssistantPA9115180FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952066250
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA CHRISTINE LONG PA-C
Provider Business Mailing Address
First Line : 5102 BELMERE PKWY APT 606
Second Line :
City : TAMPA
State : FL
Zip : 33624-6924
Country : US
Telephone Number : 772-224-0449
Fax Number :
Provider Business Practice Location Address
First Line : 5102 BELMERE PKWY APT 606
Second Line :
City : TAMPA
State : FL
Zip : 33624-6924
Country : US
Telephone Number : 772-224-0449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2021
Last Update Date : 05/19/2026

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Directions to “ KAYLA CHRISTINE LONG PA-C” Practice Location

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