License Verification

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TAMMY PRUITT MARTINEZ

License Number: PA9110936

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9110936
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
11/28/2017
Address of Record
9130 R G Skinner Parkway
First Coast Family Medicine
JACKSONVILLE, FL 32256
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
BRAUD, CHRISTINE MARIE Supervising Prescribing Practitioner Medical Doctor 115103 03/12/2018
CARO, DAVID ALAN Supervising Prescribing Practitioner Medical Doctor 73369 03/12/2018
DEVOS, ELIZABETH LOUISE Supervising Prescribing Practitioner Medical Doctor 96476 03/12/2018
DISHONG, WILLIAM P Supervising Prescribing Practitioner Medical Doctor 116690 03/12/2018
DURAN-GEHRING, PETRA E Supervising Prescribing Practitioner Medical Doctor 91161 03/12/2018
FONTANE, EMILY Supervising Prescribing Practitioner Medical Doctor 99702 03/12/2018
FREDERICKSEN, KIM ANN Supervising Prescribing Practitioner Medical Doctor 126793 03/12/2018
GALWANKAR, SAGAR CHANDRAMOHAN Supervising Prescribing Practitioner Medical Doctor 99954 03/12/2018
GODWIN, STEVEN ANDREWS Supervising Prescribing Practitioner Medical Doctor 74181 03/12/2018
KHADPE, JAY Supervising Prescribing Practitioner Medical Doctor 126242 03/12/2018
KIEL, JOHN MICHAEL Supervising Prescribing Practitioner Osteopathic Physician 15506 09/17/2018
MCINTOSH, MARK STEPHEN Supervising Prescribing Practitioner Medical Doctor 89160 03/12/2018
MORRISSEY, THOMAS KERRY Supervising Prescribing Practitioner Medical Doctor 80734 03/12/2018
ODOM, GEOFFREY LYLE Supervising Prescribing Practitioner Medical Doctor 132800 03/12/2018
PARSONS-TUCKER, MELISSA ERIN Supervising Prescribing Practitioner Medical Doctor 122791 03/12/2018
PEREIRA, CAROLINA CEBIM Supervising Prescribing Practitioner Medical Doctor 122812 03/12/2018
PERRY, PAUL K Supervising Prescribing Practitioner Medical Doctor 40177 03/12/2018
RHOADES, DENNIS WAYNE Supervising Prescribing Practitioner Osteopathic Physician 18340 03/14/2022
ROE, EDWARD JEDD III Supervising Prescribing Practitioner Medical Doctor 118390 03/12/2018
RUTLEDGE, AMANDA CRICHLOW Supervising Prescribing Practitioner Medical Doctor 130563 03/12/2018
SCHMIDT, ANDREW CHRISTOPHER Supervising Prescribing Practitioner Osteopathic Physician 12712 03/12/2018
SHANNON, ANDREW WHITE Supervising Prescribing Practitioner Medical Doctor 125247 03/12/2018
SHEIKH, SOPHIA SHAHINTAJ Supervising Prescribing Practitioner Medical Doctor 106126 03/12/2018
SHERIFALI, SINEM Supervising Prescribing Practitioner Medical Doctor 113174 03/12/2018
STORCH, IAN DAVID Supervising Prescribing Practitioner Medical Doctor 132808 03/12/2018
TOPP, STEPHEN SPENCER MD Supervising Prescribing Practitioner Medical Doctor 103463 03/12/2018
WILLIAMS, DEBORAH JEAN Supervising Prescribing Practitioner Medical Doctor 112260 03/12/2018
WU, FLORIANE Supervising Prescribing Practitioner Medical Doctor 64863 07/12/2018
WYLIE, TODD WICK Supervising Prescribing Practitioner Medical Doctor 83747 03/12/2018

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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.