License Verification

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DZI-VIET PHUOC NGUYEN

License Number: OS12020

Data As Of 12/23/2024

Profession
Osteopathic Physician
License
OS12020
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
3/31/2026
License Original Issue Date
01/24/2013
Address of Record
4600 4th St. N
ST. PETERSBURG, FL 33703
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1615 Pasadena Ave South Ste 150
SOUTH PASADENA, FL 33707
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
DAICOFF, MARK ALEXANDER Prescribing Physician Assistant Physician Assistant 9112118 8/9/2019
PICA, JOSEPH J Prescribing Physician Assistant Physician Assistant 1989 4/3/2018
WILSON, PATRICIA ANN Prescribing Physician Assistant Physician Assistant 9102428 6/26/2017

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/23/2024



* 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.