License Verification

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CARLOS JUAN GALBAN

License Number: PA9104869

Data As Of 6/30/2024

Profession
Physician Assistant
License
PA9104869
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
11/25/2008
Address of Record
975 BAPTIST WAY
BAPTIST HOSPITAL
HOMESTEAD, FL 33033
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
AGOSTINI-MIRANDA, ALEX A Supervising Prescribing Practitioner Medical Doctor 95555 11/25/2019
BORRERO-MENDOZA, ANDRES ELIAS MD Supervising Prescribing Practitioner Medical Doctor 140971 11/25/2019
BRONIAK, FREDERICK Supervising Prescribing Practitioner Osteopathic Physician 4948 11/25/2019
DIAZ, MIGUEL ANGEL Supervising Prescribing Practitioner Medical Doctor 120016 11/25/2019
DUNAVANT, SCOTT L MD Supervising Prescribing Practitioner Medical Doctor 109424 11/25/2019
GONZALEZ CARRILLO, ROYNEL Supervising Prescribing Practitioner Medical Doctor 108237 11/25/2019
MILLER, WENDI S Supervising Prescribing Practitioner Medical Doctor 110810 11/25/2019
NGUYEN, LINDA MAC Supervising Prescribing Practitioner Medical Doctor 112192 11/25/2019
NWOSU, HILARY C Supervising Prescribing Practitioner Medical Doctor 114167 11/25/2019
OLIVA, JOSEPH WAYNE Supervising Prescribing Practitioner Osteopathic Physician 10074 11/25/2019
RAZA-RODRIGUEZ, CHANDELLE GAOIRAN Supervising Prescribing Practitioner Osteopathic Physician 16616 10/21/2020
SIVARAJ, THAMOTHARAMPILLA Supervising Prescribing Practitioner Medical Doctor 137260 11/25/2019
TRANCE, GARRETT Supervising Prescribing Practitioner Osteopathic Physician 9546 11/25/2019
WILSON, LATRESIA ANN Supervising Prescribing Practitioner Medical Doctor 87826 11/25/2019
YAVARI, MEHDY Supervising Dispensing Practitioner Osteopathic Physician 11235 05/17/2021
YAVARI, MEHDY Supervising Prescribing Practitioner Osteopathic Physician 11235 11/25/2019

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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 6/30/2024



* 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.