License Verification

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FABIO DAVID PEREIRA

License Number: PA9109957

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9109957
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
10/10/2016
Address of Record
2100 NW 107th Ave
Unit 112
MIAMI, FL 33172
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
2502 N State Rd 7
HOLLYWOOD, FL 33021
Name Relationship Profession License Effective Date
ACOSTA, OMAR Supervising Prescribing Practitioner Medical Doctor 163331 11/28/2023
BEAUPORT, VIKYE Supervising Prescribing Practitioner Medical Doctor 140564 11/27/2023
BOLEY JR, GERALD Supervising Prescribing Practitioner Medical Doctor 155571 11/08/2023
CANGE, ALIX ANDRE Supervising Prescribing Practitioner Physician Assistant 9104367 11/28/2023
DIXON, SHANTERIA DUAN Supervising Prescribing Practitioner Medical Doctor 139884 02/02/2024
GABRIEL, LAURICE HELEN Supervising Dispensing Practitioner Medical Doctor 121206 05/02/2022
HENDRIX, TIMOTHY WAYNE Supervising Dispensing Practitioner Medical Doctor 65142 08/03/2021
IDEHEN, IDEMUDIA GEORGE Supervising Prescribing Practitioner Medical Doctor 160227 02/06/2024
KHER, PRAVEEN K Supervising Prescribing Practitioner Osteopathic Physician 19338 02/07/2024
MILLER, MICHAEL RAY Supervising Prescribing Practitioner Medical Doctor 129449 11/08/2023
ROSE, DAVID Supervising Prescribing Practitioner Osteopathic Physician 14774 11/15/2023
WALKER, YVONNE Supervising Prescribing Practitioner Medical Doctor 164401 11/26/2024

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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 12/22/2024



* 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.