License Verification

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RUTVI C TRIVEDI

License Number: PA9110395

Data As Of 6/15/2024

Profession
Physician Assistant
License
PA9110395
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
05/23/2017
Address of Record
12902 Magnolia Drive
2nd floor Surgical Center
TAMPA, FL 33612
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
10920 N. McKinley Drive 2nd floor
TAMPA, FL 33612
Name Relationship Profession License Effective Date
AVILA, MONICA Supervising Prescribing Practitioner Medical Doctor 156518 11/01/2022
CHERN, JING-YI Supervising Prescribing Practitioner Medical Doctor 133394 10/29/2021
CZERNIECKI, BRIAN JOSEPH Supervising Prescribing Practitioner Medical Doctor 129379 11/04/2021
GONZALEZ, RICARDO JORGE M D Supervising Prescribing Practitioner Medical Doctor 102674 11/08/2021
HOOVER, SUSAN JANE MD Supervising Prescribing Practitioner Medical Doctor 91531 11/04/2021
KHAKPOUR, NAZANIN Supervising Prescribing Practitioner Medical Doctor 100313 11/03/2021
KILUK, JOHN VINCENT Supervising Prescribing Practitioner Medical Doctor 98964 11/04/2021
LARONGA, CHRISTINE Supervising Prescribing Practitioner Medical Doctor 93499 11/03/2021
LEE, MARIE CATHERINE Supervising Prescribing Practitioner Medical Doctor 99730 11/04/2021
MALLORY, MELISSA ANNE Supervising Prescribing Practitioner Medical Doctor 145143 11/01/2021
MCMULLEN, CAITLIN Supervising Prescribing Practitioner Medical Doctor 132691 12/14/2021
MULLINAX, JOHN ELLIS Supervising Prescribing Practitioner Medical Doctor 107440 11/08/2021
OTTO, KRISTEN JOHNSON Supervising Prescribing Practitioner Medical Doctor 113364 11/11/2021
SARNAIK, AMOD ASHOK Supervising Prescribing Practitioner Medical Doctor 100184 11/09/2021
SHAHZAD, MIAN MOHAMMED KHURAM Supervising Prescribing Practitioner Medical Doctor 116161 10/29/2021
SONDAK, VERNON KEITH MD Supervising Prescribing Practitioner Medical Doctor 93133 10/26/2017
WENHAM, ROBERT MICHAEL Supervising Prescribing Practitioner Medical Doctor 92703 10/25/2021
ZAGER, JONATHAN SCOTT Supervising Prescribing Practitioner Medical Doctor 96598 10/25/2021

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Name Relationship Profession License Effective Date
MCKINNIE, NEKESHA DANIELLE Prescribing Physician Assistant Physician Assistant 9105735 4/5/2022
TERRANOVA, KELLY MAUREEN Prescribing Physician Assistant Physician Assistant 9107022 4/5/2022

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 6/16/2024



* 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.