License Verification

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JEREMY PHILIP BRENNER

License Number: PA9107287

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9107287
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
06/24/2013
Address of Record
303 NORTH CLYDE MORRIS BLVD.
HALIFAX HEALTH
DAYTONA BEACH, FL 32114
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1041 DUNLAWTON AVENUE HALIFAX HEALTH-PORT ORANGE
PORT ORANGE, FL 32127
Address
3300 halifax crossing blvd
DELTONA, FL 32725
Address
3300 Halifax Crossing Blvd Halifax Health-Deltona
DELTONA, FL 32725
Address
110 N. Orlando Ave First Choice Urgent Care
MAITLAND, FL 32751
Address
1041 Dunlawton Avenue Halifax Port Orange
PORT ORANGE, FL 32127
Name Relationship Profession License Effective Date
BAKER, KRISTEN Supervising Prescribing Practitioner Medical Doctor 136588 01/18/2019
BURGOS, ELIOE ELIO Supervising Prescribing Practitioner Medical Doctor 61835 01/18/2019
CASEY, NALINI PILLAI MD Supervising Prescribing Practitioner Medical Doctor 117107 01/18/2019
CHAN, JENNIFER Supervising Prescribing Practitioner Osteopathic Physician 14070 01/18/2019
COHEN, ETHAN Supervising Prescribing Practitioner Medical Doctor 121066 01/18/2019
CONBOY, JOHN WESCOTT Supervising Prescribing Practitioner Medical Doctor 76815 01/18/2019
DALY, ROBERT JOSEPH Supervising Prescribing Practitioner Medical Doctor 123177 01/18/2019
DOAN, HUNG Supervising Prescribing Practitioner Medical Doctor 51040 01/18/2019
GERSHEN, JESSICA BETH Supervising Prescribing Practitioner Medical Doctor 123153 01/18/2019
HALPERN, SHRAVANTI R Supervising Prescribing Practitioner Medical Doctor 125606 01/18/2019
HIGHET, BRIDGET HELEN Supervising Prescribing Practitioner Medical Doctor 116009 01/18/2019
HIRD, CINDY MAY Supervising Prescribing Practitioner Medical Doctor 106849 01/18/2019
KOCISKO, MATTHEW JOHN Supervising Prescribing Practitioner Medical Doctor 78891 01/18/2019
LAU, ANNIE Supervising Prescribing Practitioner Osteopathic Physician 13737 01/18/2019
LIBERATORE, ANNA SARAH Supervising Prescribing Practitioner Medical Doctor 114737 01/18/2019
LIGHTBURN, WINSTON EDISON Supervising Prescribing Practitioner Medical Doctor 93183 01/18/2019
MACMAHON, KEVIN Supervising Prescribing Practitioner Medical Doctor 41295 01/18/2019
MADEJCZYK, KATARZYNA IRENA Supervising Prescribing Practitioner Medical Doctor 92625 01/18/2019
MICHAEL, ALBERT MAWAD Supervising Prescribing Practitioner Medical Doctor 108947 01/18/2019
OETERS, RHONDA CAPPS MD Supervising Prescribing Practitioner Medical Doctor 129876 01/18/2019
PATTERSON, LYLE ZEKE Supervising Prescribing Practitioner Medical Doctor 116727 01/18/2019
RINGHAUSER, HOLLY Supervising Prescribing Practitioner Osteopathic Physician 15032 01/18/2019
SALTER, BRENDA HOPKINS Supervising Prescribing Practitioner Medical Doctor 56250 01/18/2019
SILVERMAN, JONATHAN JAY Supervising Prescribing Practitioner Medical Doctor 132918 01/18/2019
SOONTHAROTHAI, REWADEE Supervising Prescribing Practitioner Medical Doctor 108326 01/18/2019
SPRINGER, PETER CHARLES Supervising Prescribing Practitioner Medical Doctor 80538 01/18/2019
VIEL, STEPHEN CHARLES Supervising Prescribing Practitioner Medical Doctor 115213 01/18/2019
WILSON, TARA DAYE Supervising Prescribing Practitioner Medical Doctor 81444 01/18/2019

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 11/22/2024



* To find out more about Approved Providers, or ask a provider why the course you took is not yet listed, please visit our Continuing Education Providers page.


** Personal Development is limited to no more than 3 hours per renewal cycle. Any personal development hours in excess of this 3 hour maximum cannot be used for renewal and have been subtracted from the total available for renewal.


Please do not fax proof of Continuing Education hours to the Board Office until you have received your renewal notice in the mail.


For instructions on how to request a license certification of your Florida license to be sent to another state from the Florida Department of Health, please visit the License Certifications web page.