Raven Anderson, PA-C
Physician Assistant in Tampa, FL. Individual provider (NPI-1).
NPI number1669005195
StatusActive
Last updated in NPPESJan 29, 2026
Details
- NPI
- 1669005195
- Entity type
- Individual (NPI-1)
- Name
- Raven Anderson
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 12, 2020
- Certification date
- Jan 29, 2026
- Last updated
- Jan 29, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA9116058 | FL | Yes |
Practice location
12902 Usf Magnolia DrTampa, FL 33612-9416
Phone 813-745-4673
Mailing address
Po Box 198441Atlanta, GA 30384-8441
Phone 813-745-4673
Other practice locations
7814 N Dale Mabry Hwy
Tampa, FL 33614-3220
Tampa, FL 33614-3220
Phone 813-397-5300 · Fax 813-247-5591
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