License Verification

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MALLORY ALLYSON GAYTAN-PANDA

License Number: PA9108079

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9108079
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
08/04/2014
Address of Record
1401 West Seminole Blvd
SANFORD, FL 32771
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
1401 WEST SEMINOLE BLVD. CENTRAL FLORIDA REGIONAL
SANFORD, FL 32771
Address
8300 RED BUG LAKE RD. OVIEDO MEDICAL CENTER
OVIEDO, FL 32765
Address
380 Rinehart Rd
LAKE MARY, FL 32746
Address
4525 INTERNATIONAL PARKWAY HEATHROW ER - DIVISION OF CFRH
SANFORD, FL 32771
Address
555 SOUTH SEMINOLE HOSPITAL WEST STATE ROAD 434
LONGWOOD , FL 32750
Name Relationship Profession License Effective Date
DESAI, VIVEK S MD Supervising Prescribing Practitioner Medical Doctor 61521 03/25/2015
WALKER, TIMOTHY WOODFIN Supervising Prescribing Practitioner Medical Doctor 51072 06/30/2023

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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.