License Verification

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JENNIFER BUTTERFIELD BRODY

License Number: PA9108965

Data As Of 5/6/2025

Profession
Physician Assistant
License
PA9108965
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/03/2015
Address of Record
10080 SW Innovation Way
Suite 201
PORT ST. LUCIE, FL 34987
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
10000 SW Innovation Way Tradition Medical Center
PORT SAINT LUCIE, FL 34987
Address
1651 SE Tiffany Avenue Martin Health Physician Group Tiffany GT
PORT SAINT LUCIE, FL 34952
Address
2100 SE Salerno Rd
STUART, FL 34997
Address
200 SE Hospital Ave
STUART, FL 34994
Name Relationship Profession License Effective Date
BIRD, JUAN C Supervising Prescribing Practitioner Medical Doctor 133140 09/16/2019
FLANAGAN, EDWIN BENEDICT Supervising Prescribing Practitioner Osteopathic Physician 6311 09/16/2019
KAPPLER, STEVEN MICHAEL Supervising Prescribing Practitioner Medical Doctor 123664 09/16/2019
KOHEN, KENNETH RALPH Supervising Prescribing Practitioner Medical Doctor 37070 09/16/2019
PINEIRO, CELSO EDUARDO Supervising Prescribing Practitioner Medical Doctor 59709 09/16/2019
ROMERO MARRERO, CARLOS J Supervising Prescribing Practitioner Medical Doctor 147148 09/19/2023

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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 5/6/2025



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