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SHANNON GAYLE BERRY

License Number: ME152055

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME152055
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
07/27/2021
Address of Record
4433 Turnberry Place
Niceville
NICEVILLE, FL 32578
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
CUPO, WILLIAM WALTER MD Supervising Prescribing Practitioner Medical Doctor 86389 09/14/2022
MATTEUZZI, KATIE LOU Supervising Prescribing Practitioner Osteopathic Physician 19359 02/13/2024

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Name Relationship Profession License Effective Date
AMBROSE, JESSICA Prescribing Physician Assistant Physician Assistant 9110160 6/17/2021
BERRY, RANAE SHANNON Prescribing Physician Assistant Physician Assistant 9103545 6/17/2021
BULLMAN, JONATHAN FAIN Prescribing Physician Assistant Physician Assistant 9107709 6/17/2021
EVERETT, WARREN UMANDAP Prescribing Physician Assistant Physician Assistant 9105831 6/17/2021
GANDHI, HARMISHA Prescribing Physician Assistant Physician Assistant 9118435 4/21/2024
GLEASON, RHONDA LEE Prescribing Physician Assistant Physician Assistant 9115553 2/2/2022
JOHNSON, CHRISTOPHER DO Prescribing Physician Assistant Osteopathic Physician 9235 6/17/2021
PATRONIS ADAMS, MARIA Prescribing Physician Assistant Physician Assistant 9111206 6/17/2021
ROMAN, JULIE Prescribing Physician Assistant Physician Assistant 9111426 2/27/2023
SAMSON, JESSICA AURELIO Prescribing Physician Assistant Physician Assistant 9103076 6/17/2021
SIMMONS, LEONARD WILLIAM Prescribing Physician Assistant Physician Assistant 9103209 6/17/2021
TAYLOR, SHAWN DESHANNON Prescribing Physician Assistant Physician Assistant 9104301 7/22/2024
THOMPSON, TOMMY GLEN II Prescribing Physician Assistant Medical Doctor 128635 6/17/2021
WASHINGTON, ERIC Prescribing Physician Assistant Physician Assistant 9118438 7/22/2024
WILEY, AMY HELEN Prescribing Physician Assistant Physician Assistant 9111747 6/17/2021
WINDFELDER, CHARLES BERNARD Prescribing Physician Assistant Physician Assistant 9103273 6/17/2021

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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.