License Verification

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KRUNALI MEHTA

License Number: PA9117527

Data As Of 6/23/2024

Profession
Physician Assistant
License
PA9117527
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
06/08/2023
Address of Record
2290 Bluebird Avenue
BARTOW, FL 33830
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
ADAM-ELDIEN, RABIE IBRAHIM Supervising Prescribing Practitioner Medical Doctor 119980 05/30/2024
ALI, ATIF MIR Supervising Prescribing Practitioner Medical Doctor 122983 06/16/2024
ANUGOM, CHIDI EUGENE Supervising Prescribing Practitioner Medical Doctor 138811 05/29/2024
ATENCIO, XAVIER Supervising Prescribing Practitioner Medical Doctor 149889 06/05/2024
BANG, SUNG-WOOK JESSE Supervising Prescribing Practitioner Medical Doctor 160801 06/05/2024
BANOUB, MINA GIRGIS Supervising Prescribing Practitioner Medical Doctor 158439 06/14/2024
BEGUM, TOHMINA Supervising Prescribing Practitioner Medical Doctor 109244 05/31/2024
BROWN, O'SHAINE Supervising Prescribing Practitioner Medical Doctor 155210 06/01/2024
CESTERO, RICARDO Supervising Prescribing Practitioner Medical Doctor 98591 06/04/2024
CITTERBART, RHONEL LANIQUE Supervising Prescribing Practitioner Medical Doctor 121196 05/30/2024
DHANOA, JUGRAJ SINGH Supervising Prescribing Practitioner Medical Doctor 157147 05/29/2024
EL FAR, EYAD Supervising Prescribing Practitioner Medical Doctor 140933 05/29/2024
ELIAS- AUSI, SAMUEL SAAD Supervising Prescribing Practitioner Medical Doctor 129638 06/03/2024
GHARIB, MOHAMED A Supervising Prescribing Practitioner Medical Doctor 146656 06/11/2024
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 08/28/2023
HENDRIX, TIMOTHY WAYNE Supervising Prescribing Practitioner Medical Doctor 65142 08/28/2023
KALAVESHI, SOKOL Supervising Prescribing Practitioner Medical Doctor 144145 06/01/2024
KELMENDI, ADRIANNA Supervising Prescribing Practitioner Medical Doctor 137326 06/03/2024
LI, DEQING Supervising Prescribing Practitioner Medical Doctor 104447 05/31/2024
MABRY, TERRANCE CHRISTIAN Supervising Prescribing Practitioner Medical Doctor 160716 06/02/2024
MANDA, JAYAPRAKASH Supervising Prescribing Practitioner Medical Doctor 162658 05/16/2024
MCGOVERN, HEATHER G Supervising Prescribing Practitioner Osteopathic Physician 19894 06/01/2024
MELOELAIN, JAMIL ALI Supervising Prescribing Practitioner Medical Doctor 135241 05/31/2024
MUTTI, SUHANNA Supervising Prescribing Practitioner Medical Doctor 161650 06/06/2024
NOGUERA, GUILLERMO EMILIO Supervising Prescribing Practitioner Medical Doctor 111715 05/29/2024
OKPOKPO, ENOEMEM MICHAEL Supervising Prescribing Practitioner Osteopathic Physician 17819 05/30/2024
OLAOYE, OLATUNJI Supervising Prescribing Practitioner Medical Doctor 139026 05/30/2024
PERVEEN, SANA Supervising Prescribing Practitioner Medical Doctor 133274 05/31/2024
PHAM, TIN THANH Supervising Prescribing Practitioner Osteopathic Physician 19425 06/07/2024
ROCHE, FRANCOIS RONY Supervising Prescribing Practitioner Medical Doctor 113152 05/30/2024
ROZECKI, KAYE KIRSTEN Supervising Prescribing Practitioner Osteopathic Physician 13350 06/10/2024
SERRANO VILCA, INES ALEJANDRA Supervising Prescribing Practitioner Medical Doctor 131673 05/30/2024
SOTO, JILLIAN MARIE Supervising Prescribing Practitioner Medical Doctor 154910 06/05/2024
TABBAA, ZAID Supervising Prescribing Practitioner Medical Doctor 144690 06/02/2024
THAKUR, ANAYET UDDIN Supervising Prescribing Practitioner Medical Doctor 80853 05/29/2024
TIEN, JUNG-JUNG Supervising Prescribing Practitioner Medical Doctor 154428 06/01/2024
VEERAPANENI, VIJAY SAI Supervising Prescribing Practitioner Medical Doctor 167832 06/12/2024
VOLOSENCO, ION Supervising Prescribing Practitioner Medical Doctor 152010 05/29/2024

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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 6/23/2024



* 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.