License Verification

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DIANA DE LA CRUZ

License Number: PA9114460

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9114460
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
06/02/2021
Address of Record
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
FONTAINE, JACQUES-PIERRE Supervising Prescribing Practitioner Medical Doctor 108852 07/03/2024
TOLOZA, ERIC MIGUEL Supervising Prescribing Practitioner Medical Doctor 107905 07/09/2024

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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.


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.