Individual provider Active NPI

Carlianne Wells, PA-C

  • Physician Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1528359460
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9105887 Issued in FL
Practice address
100 SE 15TH Ave
Fort Lauderdale, FL 33301-3908
Phone
(954) 983-1899
Fax
(954) 986-6846
NPI assigned
Apr 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9105887 FL Primary

Addresses

Primary practice location

100 SE 15TH Ave
Fort Lauderdale, FL 33301-3908

Mailing address

1800 Dr Martin Luther King Jr St N
St Petersburg, FL 33704-4222
Phone (727) 865-4288

Other names 1

  • Carli Jorge Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150310000120 FL Practitioner - Physician Assistant 9638495658 Reassigns benefits to 1 organization
I20240402002490 VI Practitioner - Physician Assistant 9638495658 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Associates LLC CurrentSince Feb 21, 2025 Accepting new patients

Locations

10151 Entrprs Cntr Blvd
Ste 101
Boynton Beach, FL 33437
Phone (561) 732-2136

7841 Cambridge Manor Pl
Ste C
Fort Myers, FL 33907
Phone (239) 908-3593

4800 N Federal Hwy
Ste 200
Ft Lauderdale, FL 33308
Phone (954) 688-7269

100 SE 15th Ave
Ft Lauderdale, FL 33301
Phone (954) 607-1691

210 Jupiter Lakes Blvd
Bldg 3000
Jupiter, FL 33458
Phone (561) 677-4353

1971 SW 172nd Ave
Ste 3125
Miramar, FL 33029

1800 Dr Martin Luther King St N
St Petersburg, FL 33704
Phone (727) 821-2121

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1528359460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044222",
            "telephone_number": "727-865-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SE 15TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013908",
            "telephone_number": "954-983-1899",
            "fax_number": "954-986-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "CARLIANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLI",
            "last_name": "JORGE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.