License Verification

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MICHELLE NICOLE LASTRA

License Number: PA9111768

Data As Of 11/23/2024

Profession
Physician Assistant
License
PA9111768
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
10/22/2018
Address of Record
11406 US Hwy 301 S
RIVERVIEW, FL 33578
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
13856 N Dale Mabry Hwy
TAMPA, FL 33618
Address
2810 W M.L.K. Jr Blvd
TAMPA, FL 33607
Address
564 Channelside Drive
TAMPA, FL 33602
Address
6182 N US Highway 41
APOLLO BEACH, FL 33572
Address
40545 US Hwy 19N Unit A
TARPON SPRINGS, FL 34689
Address
5464 Lithia Pinecrest Drive
LITHIA, FL 33547
Address
16521 US Hwy 301 S
WIMAUMA, FL 33598
Address
3301 W Gandy Blvd TGH Urgent Care-South Tampa
TAMPA, FL 33611
Address
799 W Lumsden Road TGH Urgent Care-Brandan
BRANDON, FL 33511-6261
Address
13531 State Rd. 54
ODESSA, FL 33556
Address
4949 4th Street North
SAINT PETERSBURG, FL 33703
Address
22945 State Road 54
LUTZ, FL 33549
Address
19027 Wingshooter Way
LUTZ, FL 33558
Address
11969 Sheldon Road
TAMPA, FL 33626
Address
5504 Gateway Blvd
WESLEY CHAPEL, FL 33544
Address
303 W Palm Ave
TAMPA, FL 33602
Address
3251 66th St. N
SAINT PETERSBURG, FL 33710
Address
7601 Seminole Blvd
SEMINOLE, FL 33772
Address
4505 Gunn Highway
TAMPA, FL 33624
Name Relationship Profession License Effective Date
FROMMANN, NICOLE Supervising Dispensing Practitioner Medical Doctor 81429 02/15/2019
FROMMANN, NICOLE Supervising Prescribing Practitioner Medical Doctor 81429 01/25/2019
NANDA, PAUL KALRA Supervising Dispensing Practitioner Medical Doctor 117861 02/15/2019
NANDA, PAUL KALRA Supervising Prescribing Practitioner Medical Doctor 117861 01/25/2019

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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 11/23/2024



* 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.