License Verification

Printer Friendly Version

KENNETH BRIAN LEE

License Number: PA9112062

Data As Of 10/9/2025

Profession
Physician Assistant
License
PA9112062
License Status
Clear/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
02/22/2019
Address of Record
3030 4th St N
SAINT PETERSBURG, FL 33704
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
7337 University Pkwy
LAKEWOOD RANCH, FL 34202
Address
4332 Cortez Rd
BRADENTON, FL 34210
Address
10735 FL-64
BRADENTON, FL 34212
Address
3700 US Hwy 98 N Suite 101
LAKELAND, FL 33809
Address
2102 S Dale Mabry Hwy
TAMPA, FL 33629
Address
12105 W Linebaugh Ave Unit 207
WESTCHASE, FL 33626
Address
13256 State Road FL-54
ODESSA, FL 33556
Address
10943 Causeway Blvd
BRANDON, FL 33511
Address
408 E Brandon Blvd
BRANDON, FL 33511
Address
13610 Bruce B Downs Blvd
TAMPA, FL 33613
Address
3110 Fruitville Commons Blvd Suite 101
SARASOTA, FL 34240
Address
8849 State Rd 52
HUDSON, FL 34667
Address
2404 US Hwy 19
HOLIDAY, FL 34691
Address
34621 US Hwy 19
PALM HARBOR, FL 34684
Address
26812 US Hwy 19
CLEARWATER, FL 33761
Address
2420 Gulf to Bay Blvd
CLEARWATER, FL 33765
Address
10500 Ulmerton Rd
LARGO, FL 33771
Address
7321 Park Blvd
PINELLAS PARK, FL 33781
Name Relationship Profession License Effective Date
DAVIS, RANDAL LEE Supervising Dispensing Practitioner Medical Doctor 110579 08/18/2025
DAVIS, RANDAL LEE Supervising Prescribing Practitioner Medical Doctor 110579 04/25/2025
LEE, SIN PING Supervising Prescribing Practitioner Medical Doctor 91558 11/05/2023
LIVINGSTON, ROBERT TERENCE Supervising Prescribing Practitioner Medical Doctor 83159 05/01/2019
MCNAMEE, JUSTIN JAMES Supervising Prescribing Practitioner Osteopathic Physician 12888 05/01/2019
MOSES, DUSTY ALLEN DR Supervising Prescribing Practitioner Medical Doctor 115932 05/01/2019
MUCCIOLO, PAUL MD Supervising Prescribing Practitioner Medical Doctor 69281 05/01/2019
RAMIA, MICHELLE MARIE Supervising Prescribing Practitioner Medical Doctor 116871 05/01/2019
SISKO, MATTHEW DAVID Supervising Prescribing Practitioner Medical Doctor 111919 05/01/2019
WEINER, TRACY I DO Supervising Prescribing Practitioner Osteopathic Physician 7471 05/01/2019

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

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 10/9/2025



* 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.