License Verification

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KAITLYN COUCOULES

License Number: PA9110965

Data As Of 4/29/2025

Profession
Physician Assistant
License
PA9110965
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
12/18/2017
Address of Record
H. Lee Moffitt Cancer Center
12902 Magnolia Drive
TAMPA, FL 33612
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
AHMED, KAMRAN ALI Supervising Prescribing Practitioner Medical Doctor 131438 02/20/2020
DIAZ, ROBERTO Supervising Prescribing Practitioner Medical Doctor 118918 02/20/2020
NAGHAVI, ARASH OLYIE Supervising Prescribing Practitioner Medical Doctor 131559 10/21/2021
NANDA, RONICA HAZARIWALA Supervising Prescribing Practitioner Medical Doctor 130580 02/20/2020
PENAGARICANO, JOSE Supervising Prescribing Practitioner Medical Doctor 139887 02/20/2020
WASHINGTON, IMAN Supervising Prescribing Practitioner Medical Doctor 136995 07/01/2019

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Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 4/29/2025



* 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.