License Verification

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ALAN RYAN BLACKBURN II

License Number: ME130977

Data As Of 4/19/2025

Profession
Medical Doctor
License
ME130977
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2027
License Original Issue Date
01/19/2017
Address of Record
1050 SE Monterey Road
Suite 400
STUART, FL 34994
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
9401 SW Discovery Way Suite 201
PORT SAINT LUCIE, FL 34987
Address
9401 SW Discovery Way Suite 101
PORT SAINT LUCIE, FL 34987
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
AVIDON, PAUL I Prescribing Physician Assistant Physician Assistant 1609 8/21/2024
BARNEWOLD, KEVIN FRANCIS Prescribing Physician Assistant Physician Assistant 9102603 8/21/2024
BUSSOM, SCOTT Prescribing Physician Assistant Physician Assistant 9114250 8/21/2024
COBB, TARA ANN Prescribing Physician Assistant Physician Assistant 9101659 8/21/2024
DEMARCO, NICHOLAS ERNEST Prescribing Physician Assistant Physician Assistant 9109406 8/21/2024
FELDMAN, TED MARSHALL Prescribing Physician Assistant Physician Assistant 9113062 8/21/2024
GINSBURG, EVAN Prescribing Physician Assistant Physician Assistant 9117168 6/26/2023
HOLSCHWANDER, DAMIAN Prescribing Physician Assistant Physician Assistant 9117363 6/26/2023
MATHEW, ROYCE THOMAS Prescribing Physician Assistant Physician Assistant 9112762 8/21/2024
MCGANNON, ANDREA NICOLE Prescribing Physician Assistant Physician Assistant 9116067 3/12/2024
MUSCARELLA, DARRIN JAMES Prescribing Physician Assistant Physician Assistant 9117971 3/12/2024
PALLATTO, KYM ANGELA Prescribing Physician Assistant Physician Assistant 9106272 8/21/2024
REED, JAYCE IAN Prescribing Physician Assistant Physician Assistant 9109221 7/22/2024
RODRIGUEZ, FELIX Prescribing Physician Assistant Physician Assistant 9114185 7/22/2024

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 4/20/2025



* 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.