License Verification

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TRENT SMITH BRISTER

License Number: PA3641

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA3641
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/08/1998
Address of Record
2627 West Eau Gallie Blvd.
Suite 101
MELBOURNE, FL 32935
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
8745 N. Wickham Rd.
VIERA, FL 32940
Address
701 W. Cocoa Beach Causeway
COCOA BEACH, FL 32931
Address
1425 MALABAR RD. N.E. PALM BAY HOSPITAL
PALM BAY, FL 32907
Address
1350 SOUTH HICKORY STREET HOLMES REGIONAL MEDICAL CENTER
MELBOURNE, FL 32901
Name Relationship Profession License Effective Date
ALVAREZ, COREY Supervising Prescribing Practitioner Medical Doctor 131625 09/22/2017
CHAO, MAURICE JAY Supervising Prescribing Practitioner Osteopathic Physician 8629 11/15/2018
CROSS, WILLIAM IAN Supervising Prescribing Practitioner Osteopathic Physician 10316 10/25/2022
DEVAUX, MIKAELA ELISE Supervising Prescribing Practitioner Medical Doctor 130853 09/22/2017
D'ONOFRIO, KALI RAE Supervising Prescribing Practitioner Osteopathic Physician 12738 11/15/2018
DUCKWORTH, ANGELA LEEANN MD Supervising Prescribing Practitioner Medical Doctor 112929 11/15/2018
FLEMING, MICHAEL MD Supervising Prescribing Practitioner Medical Doctor 133576 11/15/2018
HABIB, LAILA NICOLE Supervising Prescribing Practitioner Physician Assistant 9111509 10/25/2022
JONES JR, PRESTON M Supervising Prescribing Practitioner Medical Doctor 162801 08/17/2023
JONES, PRESTON MICHAEL MD Supervising Prescribing Practitioner Medical Doctor 51045 11/15/2018
MCGOOHAN, MICHAEL PATRICK DO Supervising Prescribing Practitioner Osteopathic Physician 6325 11/15/2018
MONTGOMERY, ELISHA ANNE Supervising Prescribing Practitioner Medical Doctor 122062 09/22/2017
PIRAZZI-MARQUEZ, BEATRIZ M Supervising Prescribing Practitioner Medical Doctor 102083 10/25/2023
RAMAGE, DARRON TRAVIS Supervising Prescribing Practitioner Medical Doctor 115024 08/26/2019
ROTOLO, ALYSSA BIXBY Supervising Prescribing Practitioner Medical Doctor 127035 11/15/2018
STOJANOVSKI, MIHAIL METODIJA Supervising Prescribing Practitioner Medical Doctor 130869 09/22/2017
TAIVAL, BRANDON JEAN DO Supervising Prescribing Practitioner Osteopathic Physician 9481 11/15/2018
WALKER, GEORGE HAROLD MD Supervising Prescribing Practitioner Medical Doctor 70189 11/15/2018
WEBER, DOUGLAS ANTHONY Supervising Prescribing Practitioner Medical Doctor 143900 05/06/2020
WEEMAN, MITCHELL Supervising Prescribing Practitioner Medical Doctor 160791 07/26/2023
YOUNG, VICTOR CHANCE Supervising Prescribing Practitioner Osteopathic Physician 8339 04/26/2016

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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.