License Verification

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MICHAEL CHRISTOPHER HANES

License Number: ME121093

Data As Of 11/16/2024

Profession
Medical Doctor
License
ME121093
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
07/28/2014
Address of Record
5191 First Coast Tech Pkwy
3rd Floor
JACKSONVILLE, FL 32224
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Yes
Discipline on File
No
Public Complaint
No
Address
1100 Plantation Island Drive S Suite 220
SAINT AUGUSTINE, FL 32080
Address
6100 St. Johns Avenue Suite 4
PALATKA, FL 32177
Address
2349 Village Square Pkwy Suite 107
FLEMING ISLAND, FL 32003
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
BLANK, CHRISTINE O'REILLY AA Anesthesiologist Assistants 520 1/1/2019
BLANKENSHIP, BROCK DANIEL AA Anesthesiologist Assistants 395 1/1/2019
CALKINS, GINAH HOPE CHOI AA Anesthesiologist Assistants 96 9/1/2017
CLEMONS, CARSON MITCHELL Prescribing Physician Assistant Physician Assistant 9114474 10/6/2021
CRISWELL, COURTNEY RAE Prescribing Physician Assistant Physician Assistant 9111862 3/16/2020
DIEHL, DAVID RYAN AA Anesthesiologist Assistants 343 1/1/2019
DIEHL, DAVID RYAN Subordinate Anesthesiologist Assistants 343 3/21/2017
MASSEY, JOSHUA BRIAN Prescribing Physician Assistant Physician Assistant 9104570 6/19/2019
MCWILLIAMS, BRIAN JASON Subordinate Anesthesiologist Assistants 37 1/1/2019
ORTIZ, MARCUS LUIS Subordinate Anesthesiologist Assistants 410 1/1/2019
SMITH, MEGAN ANNE Prescribing Physician Assistant Physician Assistant 9107059 9/14/2022
TALLEY, JOHN DAVID AA Anesthesiologist Assistants 355 1/1/2019
TALLEY, JOHN DAVID Subordinate Anesthesiologist Assistants 355 1/25/2017
TRACE, TAYLOR Prescribing Physician Assistant Physician Assistant 9112637 3/16/2020

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 11/16/2024



* 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.