In a medium saucepan bring coconut milk just to boiling. Stir in rice, cover and simmer 18 to 20 minutes or until all of the liquid is absorbed.
Meanwhile, coat a nonstick skillet with nonstick cooking spray and place over medium heat. Add tilapia; cook 3 minutes per side. Add 1/2 cup water, lime juice, carrot and garlic. Cover and simmer 4 to 6 minutes or until fish easily flakes with a fork. Remove from heat. Break tilapia into large bite-size pieces.
Fluff rice with a fork; stir in lime peel and cilantro. Season with salt and pepper to taste. Spoon rice into bowls, spoon tilapia mixture on rice and serve.