License Verification

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AUDREY CAMILLE SEVILLA-BALLEREAU

License Number: PA9108569

Data As Of 12/23/2024

Profession
Physician Assistant
License
PA9108569
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
02/10/2015
Address of Record
3001 W. DR. MARTIN LUTHER KING
Jr. BLVD., MAB 2ND FLOOR
CARDIOVASCULAR AND THORACIC DEPARTMENT
TAMPA, FL 33607
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
3003 W. Dr. MLK Jr. Blvd., MAB 2nd Floor BayCare Medical Group, Inc
TAMPA, FL 33607
Name Relationship Profession License Effective Date
CHAVARRIAGA, LUIS FELIPE Supervising Prescribing Practitioner Medical Doctor 117008 11/26/2019
POWELL, ALEXIS REA Supervising Prescribing Practitioner Medical Doctor 116752 11/26/2019

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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 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.