License Verification

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CRUZ MARTINA FANA-SOUCHET

License Number: ME96750

Data As Of 5/15/2025

Profession
Medical Doctor
License
ME96750
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2027
License Original Issue Date
08/17/2006
Address of Record
125 Patricia Ave.
Suite# A,B,C,D
DUNEDIN, FL 34698
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
1280 Missouri Ave. N
LARGO, FL 33770
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
BUI, PHUONG YEN Dispensing Physician Assistant Physician Assistant 9107732 2/1/2023
BUI, PHUONG YEN Prescribing Physician Assistant Physician Assistant 9107732 7/31/2017
LOVE, BENJAMIN EDWARD Dispensing Physician Assistant Physician Assistant 9110134 2/1/2023
LOVE, BENJAMIN EDWARD Prescribing Physician Assistant Physician Assistant 9110134 12/15/2020
TRAN, TRICIA VU Prescribing Physician Assistant Physician Assistant 9119007 11/27/2024

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 5/15/2025



* 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.


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