License Verification

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MARTINA MARIE NIMETH

License Number: PA9102555

Data As Of 11/22/2024

Profession
Physician Assistant
License
PA9102555
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/04/2003
Address of Record
2627 West Eau Gailie 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
2627 West Eau Gailie Blvd Suite 101
MELBOURNE, FL 32935
Address
12100 SOUTH JOHN YOUNG PARKWAY HUNTERS CREEK ER
ORLANDO, FL 32837
Address
8745 N Wickham Road Viera Hospital
MELBOURNE, FL 32940
Address
701 W Cocoa Beach Causeway Cape Canaveral Hospital
COCOA BEACH, FL 32931
Address
1425 Malabar Road NE Palm Bay Community Hospital
PALM BAY, FL 32907
Address
1350 South Hickory Street Holmes Regional ER
MELBOURNE, FL 32901
Address
4056 Millenia Blvd Millenia ER
ORLANDO, FL 32839
Name Relationship Profession License Effective Date
AGOSTO DIAZ, EDIL J Supervising Prescribing Practitioner Medical Doctor 102761 02/28/2021
BRONSTEMA, CLARENCE JAMES DO Supervising Prescribing Practitioner Osteopathic Physician 9722 02/03/2021
BROWN, MARTY RAY M D Supervising Prescribing Practitioner Medical Doctor 75648 02/03/2021
CSORTAN, ERIC STEVEN Supervising Prescribing Practitioner Medical Doctor 84708 02/03/2021
DEVAUX, MIKAELA ELISE Supervising Prescribing Practitioner Medical Doctor 130853 06/16/2021
DEVEREAUX, DANIELLE Supervising Prescribing Practitioner Medical Doctor 129224 02/03/2021
DUDLEY, LARISSA SOPHIA Supervising Prescribing Practitioner Medical Doctor 131434 02/06/2021
FOSTER, QUINTON ADAM Supervising Prescribing Practitioner Medical Doctor 168147 08/14/2024
GAGEN, JAMES SHAWN Supervising Prescribing Practitioner Osteopathic Physician 10263 02/03/2021
GREEN, DOUGLAS WARREN MD Supervising Prescribing Practitioner Medical Doctor 81481 02/15/2021
GRIFFIN, JOHN PATRICK MD Supervising Prescribing Practitioner Medical Doctor 78523 02/04/2021
GUTTA, RAJESH Supervising Prescribing Practitioner Medical Doctor 82886 02/03/2021
HEIST, DORAN ROBERT MD Supervising Prescribing Practitioner Medical Doctor 111822 06/16/2021
HOMERICK, MICHAEL JOHN Supervising Prescribing Practitioner Medical Doctor 119113 02/04/2021
JOCKOVICH, MILAN MD Supervising Prescribing Practitioner Medical Doctor 65559 02/02/2021
JONES JR, PRESTON M Supervising Prescribing Practitioner Medical Doctor 162801 08/17/2023
LLINAS, JACQUELINE B MD Supervising Prescribing Practitioner Medical Doctor 68727 02/05/2021
MATHEW, DANA RICHARDS MD Supervising Prescribing Practitioner Medical Doctor 128175 02/26/2021
MCGOOHAN, MICHAEL PATRICK DO Supervising Prescribing Practitioner Osteopathic Physician 6325 06/08/2021
MILES, JAMES TIMOTHY Supervising Prescribing Practitioner Medical Doctor 76017 02/03/2021
OLIVEIRA, BRIAN MARIO Supervising Prescribing Practitioner Medical Doctor 110586 02/23/2021
OSWALD, NED ANTHONY MD Supervising Prescribing Practitioner Medical Doctor 121076 02/04/2021
PIRAZZI-MARQUEZ, BEATRIZ M Supervising Prescribing Practitioner Medical Doctor 102083 02/28/2021
ST CLAIR, AARON LEE Supervising Prescribing Practitioner Medical Doctor 106075 02/28/2021
STOJANOVSKI, MIHAIL METODIJA Supervising Prescribing Practitioner Medical Doctor 130869 02/21/2021
TYMKOWICZ, ALEXANDRIA Supervising Prescribing Practitioner Medical Doctor 156308 03/14/2023
VAZQUEZ, JOHNNY J Supervising Prescribing Practitioner Medical Doctor 97644 02/03/2021
WEEMAN, MITCHELL Supervising Prescribing Practitioner Medical Doctor 160791 07/26/2023

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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.