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KALYAN C MANTHA

License Number: ME122523

Data As Of 5/20/2024

Profession
Medical Doctor
License
ME122523
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
12/30/2014
Address of Record
1916 Dumfries Ct
SAINT JOHNS, FL 32259
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
DEJESUS JARQUIN, OTILIA Supervisor Medical Doctor 105497 04/01/2019
HOIDA, JEFFREY SCOTT MD Supervisor Medical Doctor 136257 04/01/2019
HOIDA, SHIELDS DUSS Supervisor Medical Doctor 125526 04/01/2019
MENDEZ, LORRAINE MD Supervising Prescribing Practitioner Medical Doctor 120528 06/30/2023

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Name Relationship Profession License Effective Date
ALZATE, ALBERTO ISAAC Prescribing Physician Assistant Medical Doctor 81335 8/19/2020
BAUERNFEIND, ADAM MICHAEL Prescribing Physician Assistant Physician Assistant 9111280 9/25/2018
BRANNING, MEGHAN LEIGH Prescribing Physician Assistant Physician Assistant 9110029 9/20/2018
BRUCE, MICHAEL THOMAS Prescribing Physician Assistant Physician Assistant 9109680 9/20/2018
CRISSMAN, WILLIAM WARD Prescribing Physician Assistant Physician Assistant 9105322 9/20/2018
DODSON, JENNY MARIA Prescribing Physician Assistant Physician Assistant 9104645 4/13/2020
DODSON, PATRICK RUSSELL Prescribing Physician Assistant Physician Assistant 9110653 9/25/2018
DOWNEY, THOMAS JACKSON Prescribing Physician Assistant Physician Assistant 9109946 4/13/2020
EISMONT, TRACEY JEAN Prescribing Physician Assistant Physician Assistant 3182 8/15/2018
FEHR, LORI L Prescribing Physician Assistant Physician Assistant 9107477 9/20/2018
FENN, GREGORY ALAN Prescribing Physician Assistant Physician Assistant 9108811 9/24/2018
FINKLEA, TERI LYNN Prescribing Physician Assistant Medical Doctor 115273 8/24/2020
FORTNER, DENNIS LEROY III Prescribing Physician Assistant Physician Assistant 9105894 9/20/2018
GAVLIK, MORGAN PAIGE Prescribing Physician Assistant Physician Assistant 9110306 9/25/2018
GOINS, DAVID SCOTT Prescribing Physician Assistant Physician Assistant 9102736 9/18/2018
HINSON, JACOB CODY Prescribing Physician Assistant Physician Assistant 9108842 6/24/2019
HINTON, JENNIFER MARIE Prescribing Physician Assistant Physician Assistant 9103166 9/20/2018
HOFFMAN, SUSAN Prescribing Physician Assistant Physician Assistant 9106725 9/18/2018
HOIDA, SHIELDS DUSS Prescribing Physician Assistant Medical Doctor 125526 8/24/2020
JURICH, ANGEL CHRISTINE Prescribing Physician Assistant Physician Assistant 9108136 9/20/2018
KARIMU, MOSHOOD BABATUNDE Prescribing Physician Assistant Medical Doctor 120289 9/19/2018
KARIMU, MOSHOOD BABATUNDE Subordinate Medical Doctor 120289 9/1/2018
LUKACSA, THOMAS DAVID Prescribing Physician Assistant Physician Assistant 9104358 9/19/2018
MARTIN, AMBER REBEKAH Prescribing Physician Assistant Physician Assistant 9103989 9/20/2018
MARTIN, DEVIN REECE Prescribing Physician Assistant Physician Assistant 9109422 9/20/2018
MCCAFFREY, KEVIN PATRICK Prescribing Physician Assistant Physician Assistant 9105009 9/20/2018
MCMONIGLE, TRACY LEE Prescribing Physician Assistant Physician Assistant 9105808 9/24/2018
MOFFATT, MEGAN H Prescribing Physician Assistant Physician Assistant 9106786 9/20/2018
MORGAN, DANIEL MUZON Prescribing Physician Assistant Physician Assistant 9107682 9/19/2018
NICOLOSO, FRANCESCA MARINA Prescribing Physician Assistant Physician Assistant 9107277 9/20/2018
PFAFF, RUTH ANNE Prescribing Physician Assistant Physician Assistant 9110750 9/19/2018
RITCHIE, MARK SALVATORE Prescribing Physician Assistant Physician Assistant 9107818 12/10/2018
SASSO, LEONARD GERARD Prescribing Physician Assistant Physician Assistant 9105451 9/19/2018
SCHMIDT, ANNE CATHERINE Prescribing Physician Assistant Physician Assistant 9105181 9/25/2018
SCOTT, RANDALL EUGENE Prescribing Physician Assistant Physician Assistant 9103913 1/27/2022
SHI, KATLIN PALMER Prescribing Physician Assistant Physician Assistant 9109389 9/24/2018
SMITH, CAROLINE OLGA Prescribing Physician Assistant Physician Assistant 9106283 9/19/2018
WALKER, RACHEL Prescribing Physician Assistant Physician Assistant 9111179 9/20/2018
WARD, MATTHEW MORGAN Prescribing Physician Assistant Physician Assistant 9108249 9/19/2018
WARD, WILLIAM ALBERT Prescribing Physician Assistant Physician Assistant 9108936 9/1/2018
WATERS, DOUGLAS LEE Prescribing Physician Assistant Physician Assistant 9106355 9/1/2018
WEAVER, ADAM CHRISTOPHER Prescribing Physician Assistant Physician Assistant 9103017 9/19/2018
YEAZITZIS, CHANDLER LARSEN Prescribing Physician Assistant Physician Assistant 9109042 9/21/2018

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 5/21/2024



* 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.