License Verification

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THAMOTHARAMPILLA SIVARAJ

License Number: ME137260

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME137260
License Status
OBLIGATIONS/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
07/16/2018
Address of Record
8912 NW,161 Baptist Hospital
Homestead Hospital
8912 NW,161 Terr
MIAMI LAKES, FL 33018
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
Yes - Click on Discipline/Admin Action tab to see more details
Public Complaint
Yes - Click on Discipline/Admin Action tab to see more details
Address
975 Baptist Way
HOMESTEAD, FL 33033
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
ALI, MOHAMED SYAD Prescribing Physician Assistant Physician Assistant 9104732 12/10/2019
CRUZ, ARCENIO JOEL Prescribing Physician Assistant Physician Assistant 9107371 12/3/2019
DOMINGUEZ, PAULINA Prescribing Physician Assistant Physician Assistant 9106727 2/11/2020
FARMER, SANDRA PATRICIA Prescribing Physician Assistant Physician Assistant 9102664 1/10/2020
GALBAN, CARLOS JUAN Prescribing Physician Assistant Physician Assistant 9104869 11/25/2019
HERNANDEZ, DINORAH Prescribing Physician Assistant Physician Assistant 9104533 12/11/2019
PETERS, SILVIA ANN Prescribing Physician Assistant Physician Assistant 9102825 12/19/2019
SALAZAR, LUIS E Prescribing Physician Assistant Physician Assistant 9108095 12/2/2019
VUST, LAVERLE JAMES Prescribing Physician Assistant Physician Assistant 2491 12/3/2019

Click on the License Number to view License Details for that Practitioner

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.