License Verification

Printer Friendly Version

KRISTIN MARIE WAGNER

License Number: PA9106405

Data As Of 4/29/2025

Profession
Physician Assistant
License
PA9106405
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/19/2012
Address of Record
111 East Hibiscus Blvd
Florida Kidney Physicians
MELBOURNE, FL 32901
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
FALDU, CHIRAG RAMNIKLAL Supervising Prescribing Practitioner Medical Doctor 111351 05/06/2019
KRIETE, RHODES MARTIN Supervising Prescribing Practitioner Medical Doctor 63696 05/06/2019
RODRIGUEZ, WAYNE DENNIS MD Supervising Prescribing Practitioner Medical Doctor 35594 05/06/2019
SPIES, CLAUS PETER M D Supervising Prescribing Practitioner Medical Doctor 79616 05/06/2019
TRIVEDI, DISHA DHARMDEV Supervising Prescribing Practitioner Medical Doctor 117749 05/06/2019

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 4/29/2025



* 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.