License Verification

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JEAN MARIE WALLNER

License Number: PA9104785

Data As Of 4/27/2025

Profession
Physician Assistant
License
PA9104785
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/16/2008
Address of Record
6919 N Dale Mabry Hwy
ste 125
TAMPA, FL 33614
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
7171 N. dale mabry
TAMPA, FL 33614
Address
3100 E. Fletcher Ave
TAMPA, FL 33613
Address
3000 Medical Park Drive ste 300
TAMPA, FL 33613
Name Relationship Profession License Effective Date
ABELA, OLIVER GEORGE Supervising Prescribing Practitioner Medical Doctor 136178 04/29/2019
AGOCHA, AUGUSTINE ENYINNA Supervising Prescribing Practitioner Medical Doctor 111542 09/01/2021
ARMANIOUS, MERNA AMIN M D Supervising Prescribing Practitioner Medical Doctor 131935 08/31/2021
CANEDO, MARIO ISMAEL Supervising Prescribing Practitioner Medical Doctor 38331 04/29/2019
COTO, HUMBERTO ALFONSO MD Supervising Prescribing Practitioner Medical Doctor 47485 04/29/2019
DELGADO, FRANCISCO JAVIER Supervising Prescribing Practitioner Osteopathic Physician 10920 09/03/2021
GARCIA, JUAN A Supervising Prescribing Practitioner Medical Doctor 39765 04/29/2019
KAPADIA, PAVAN DILIP Supervising Prescribing Practitioner Medical Doctor 141852 01/09/2020
O'HARA, MITCHELL B DO Supervising Prescribing Practitioner Osteopathic Physician 5698 04/29/2019
PASCUAL, EDUARDO ENRIQUE MD Supervising Prescribing Practitioner Medical Doctor 50832 04/29/2019
SMITH, JAMES OTWELL Supervising Prescribing Practitioner Medical Doctor 48314 04/29/2019

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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 4/27/2025



* 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.