License Verification

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HANSEL DAVID BAEZ

License Number: PA9110644

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9110644
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/07/2017
Address of Record
13020 Telecom Parkway N
TEMPLE TERRACE, FL 33637
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
DESSUREAULT, SOPHIE Supervising Prescribing Practitioner Medical Doctor 87239 11/12/2021
FELDER, SETH Supervising Prescribing Practitioner Medical Doctor 132608 11/05/2021
MALAFA, MOKENGE PETER Supervising Prescribing Practitioner Medical Doctor 91541 11/18/2021
NAFFOUJE, SAMER ALEXANDER Supervising Prescribing Practitioner Medical Doctor 140536 03/01/2022
PIMIENTO ECHEVERRY, JOSE MARIO Supervising Prescribing Practitioner Medical Doctor 105668 11/02/2021

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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.


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