License Verification

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5040 MD MANAGEMENT CORP

Vixen Plastic Surgery

License Number: OSR1567

Data As Of 5/17/2025

Profession
Office Surgery Registration
License
OSR1567
License Status
CLEAR/
Qualifications
Surgery w moderate/conscious to deep sedation
License Expiration Date
License Original Issue Date
03/05/2021
Address of Record
5040 NW 7 ST
SUITE 822
MIAMI, FL 33126
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
AGUELLES, GILVER Additional Surgical Staff Unlicensed Facility Personnel 04/09/2025
ALFONSO, IVON MARIA Anesthesia Provider Advanced Practice Registered Nurse 11015765 03/13/2024
ALLY, CHRISTOPHER AFDAL Anesthesia Provider Advanced Practice Registered Nurse 9284176 07/12/2021
ATAURY- BARBERO, JOSE CARLOS Anesthesia Provider Advanced Practice Registered Nurse 11015287 08/19/2022
AVALOS, YEESY Additional Surgical Staff Unlicensed Facility Personnel 07/13/2022
AVILA ORTEGA, MIGUEL EUSTASIO Additional Surgical Staff Advanced Practice Registered Nurse 11012150 03/29/2021
BROWN, STEPHANIE MARIA Anesthesia Provider Advanced Practice Registered Nurse 11007016 10/10/2023
CAMPOS, GLEIDA Additional Surgical Staff Unlicensed Facility Personnel 01/13/2025
CANALES ACOSTA, FLOR ELISA Recovery Registered Nurse 9643425 10/27/2023
CANNON, CLIFTON LAMAR III Physician Medical Doctor 146078 03/16/2021
CORNISH, ALEXANDRA MARIA MS Anesthesia Provider Advanced Practice Registered Nurse 9243777 08/18/2021
CORREA GOMEZ, MELISSA Additional Surgical Staff Unlicensed Facility Personnel 01/28/2024
CORREA MEDINA, MIGUEL Additional Surgical Staff Unlicensed Facility Personnel 01/28/2024
DEAN, VIVIANE A Anesthesia Provider Advanced Practice Registered Nurse 9279190 10/28/2024
DEL RISCO, JESUS LAZARO Anesthesia Provider Advanced Practice Registered Nurse 2512552 11/21/2023
DIAZ, IAN Anesthesia Provider Advanced Practice Registered Nurse 11024169 01/13/2025
DIEGUEZ, LOURDES Anesthesia Provider Advanced Practice Registered Nurse 3117612 05/22/2024
DIETSCH, GABRIEL Anesthesia Provider Advanced Practice Registered Nurse 9248348 08/04/2022
DOMINGO, CYNTHIA DUMAPIT Anesthesia Provider Advanced Practice Registered Nurse 9272028 09/11/2023
ESCOBAR, DANIEL BENJAMIN Anesthesia Provider Advanced Practice Registered Nurse 11005621 09/23/2024
FALERO DURAN, LUIS X Anesthesia Provider Advanced Practice Registered Nurse 11012517 10/10/2023
FRIAS SANCHEZ, ULISES Anesthesia Provider Advanced Practice Registered Nurse 11009554 06/20/2022
FUENTES, MERCEDES CRISTINA Recovery Registered Nurse 9485039 05/21/2021
FUSTER BLANCO, LORENA Additional Surgical Staff Certified Nursing Assistant 431445 03/17/2025
GARCIA, YOENDI Office Manager Unlicensed Facility Personnel 10/09/2023
GONZALEZ, DANIEL Officer Unlicensed Facility Personnel 03/05/2021
GONZALEZ, JOSE Additional Surgical Staff Unlicensed Facility Personnel 07/13/2022
HERNANDEZ, GRETTEL Anesthesia Provider Advanced Practice Registered Nurse 11005565 01/28/2024
LARA, REYNIER Agent Unlicensed Facility Personnel 03/05/2021
LARA, REYNIER Officer Unlicensed Facility Personnel 03/05/2021
LARA, REYNIER Owner Unlicensed Facility Personnel 03/05/2021
LASTRE, PABLO Additional Surgical Staff Unlicensed Facility Personnel 05/21/2021
LEON, MIGUEL ANGEL Anesthesia Provider Advanced Practice Registered Nurse 9176554 10/28/2024
MESA BATISTA, AMNIEL MR Anesthesia Provider Advanced Practice Registered Nurse 9329514 10/12/2023
MUNOZ, DANNY RENE Anesthesia Provider Advanced Practice Registered Nurse 9311468 11/01/2021
OLIVA, MARCOS RAFAEL Anesthesia Provider Advanced Practice Registered Nurse 9426020 09/11/2023
ORTIZ, EVELYN Anesthesia Provider Advanced Practice Registered Nurse 9258699 11/14/2024
ORTIZ, YUMARA Additional Surgical Staff Unlicensed Facility Personnel 07/28/2021
PEREZ, MARIBEL Additional Surgical Staff Unlicensed Facility Personnel 04/09/2025
PEREZ, ROXANA Additional Surgical Staff Unlicensed Facility Personnel 03/15/2021
PEREZ-VELEZ, WILFRED JUNIOR Anesthesia Provider Advanced Practice Registered Nurse 9469917 12/02/2021
RIVAS, GABRY ANTONIO Anesthesia Provider Advanced Practice Registered Nurse 11000769 08/22/2023
RIVERA, KATHERINE JANIS Anesthesia Provider Advanced Practice Registered Nurse 9473322 10/10/2023
RODRIGUEZ, ADA Additional Surgical Staff Unlicensed Facility Personnel 04/09/2025
RODRIGUEZ, LUIS Additional Surgical Staff Unlicensed Facility Personnel 07/13/2022
SANCHEZ-WILSON, CAROLINA CONCEPCION Anesthesia Provider Advanced Practice Registered Nurse 9231795 02/17/2023
SANDOVAL VAXQUEZ, MARIA Additional Surgical Staff Unlicensed Facility Personnel 01/13/2025
SINGH, UMAISH SHARMA MR Anesthesia Provider Advanced Practice Registered Nurse 9329310 10/10/2023
SINGH, YEANNIE MRS Anesthesia Provider Advanced Practice Registered Nurse 9325223 01/28/2024
TRIGGS, WILTON LEE Designated Physician Medical Doctor 151813 07/06/2023
TRIGGS, WILTON LEE Physician Medical Doctor 151813 01/27/2022
VALLADARES, ERIC RAUL MD Physician Medical Doctor 91049 07/19/2023
VEGA, PAUL MICHAEL Anesthesia Provider Advanced Practice Registered Nurse 11000770 08/19/2022

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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 5/17/2025



* 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.