License Verification

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KEVIN D STAPLETON

License Number: PA2602

Data As Of 10/7/2025

Profession
Physician Assistant
License
PA2602
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
02/19/1993
Address of Record
SOUTH LAKE HOSPITAL ER
1099 CITRUS TOWER BLVD
CLERMONT, FL 34711
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
Yes - Click on Discipline/Admin Action tab to see more details
Public Complaint
No
Address
1512 S. ORANGE AVE.
ORLANDO, FL 32806
Address
1099 CITRUS TOWER BLVD. SOUTH LAKE HOSPITAL EMERGENCY DEPT.
CLERMONT, FL 34711
Address
2600 Westhall Lane AdventHealth Centra Care
MAITLAND, FL 32751
Address
22316 US 27
LEESBURG, FL 34748
Address
16966 Cagan Ridge Blvd
CLERMONT, FL 34711
Name Relationship Profession License Effective Date
ALEXANDER, JULIE GOMPERS Supervising Prescribing Practitioner Osteopathic Physician 14675 12/19/2024
ANSARI, MASOOD UL-HASSAN Supervising Prescribing Practitioner Medical Doctor 76511 06/25/2025
EUBANKS, TRAVIS Supervising Prescribing Practitioner Osteopathic Physician 18649 07/09/2025
HUSSEIN, MALEK SHUKRI Supervising Prescribing Practitioner Medical Doctor 129091 07/12/2025
KOLODCHAK, JENNIFER LYNN Supervising Prescribing Practitioner Medical Doctor 107844 06/25/2025
LAZCANO, ANTONIO MARIA Supervising Prescribing Practitioner Medical Doctor 108060 05/18/2025
MURPHY, ANDREW CHARLES Supervising Prescribing Practitioner Medical Doctor 114173 05/18/2025
PELLY, AMANDA JANE Supervising Prescribing Practitioner Medical Doctor 125040 07/01/2025
PHILLIPS, CHRISTOPHER JOHN Supervising Prescribing Practitioner Medical Doctor 137545 06/22/2025
POKHAREL, SUNIL Supervising Prescribing Practitioner Medical Doctor 137704 09/01/2025
PUREWAL, AMARPAL K Supervising Prescribing Practitioner Medical Doctor 121581 05/21/2025
REDDY, MOVVA NAVIN Supervising Prescribing Practitioner Medical Doctor 93812 11/22/2024
RICHMOND, NEAL J Supervising Prescribing Practitioner Medical Doctor 159705 08/28/2025
RIVERA Y PIEROLA, CARLA FABIOLA Supervising Prescribing Practitioner Medical Doctor 111032 05/22/2025
SHAHID, MALIK Supervising Prescribing Practitioner Medical Doctor 171959 09/03/2025
SKINNER, CHASTITY FOWLER Supervising Prescribing Practitioner Osteopathic Physician 13923 09/03/2025
SPRY, DONAL JEREMY Supervising Prescribing Practitioner Osteopathic Physician 11298 11/11/2024

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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 10/7/2025



* 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.