License Verification

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ROYCE THOMAS MATHEW

License Number: PA9112762

Data As Of 4/29/2025

Profession
Physician Assistant
License
PA9112762
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
10/28/2019
Address of Record
1395 S. State Rd 7, Suite 410
HSS Florida-Wellington
WELLINGTON, FL 33414
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
9401 SW Discovery Way Suite 101
PORT SAINT LUCIE, FL 34987
Address
300 Palm Beach Lakes Blvd HSS Florida
WEST PALM BCH, FL 33401
Name Relationship Profession License Effective Date
BLACKBURN II, ALAN RYAN Supervising Prescribing Practitioner Medical Doctor 130977 08/21/2024
CANNADY, DARRYL FOUNTANE PETTY Supervising Prescribing Practitioner Medical Doctor 157348 09/26/2022
CARLSON, WILLIAM ERIC Supervising Prescribing Practitioner Medical Doctor 67339 07/22/2024
CERMINARA, ANTHONY JOHN Supervising Prescribing Practitioner Medical Doctor 118649 05/11/2022
PIERRE-PIERRE, GRACIA MARTIN Supervising Prescribing Practitioner Medical Doctor 119703 07/19/2024
SAMA, NICHOLAS Supervising Prescribing Practitioner Medical Doctor 91084 01/27/2020
UPADHYAYA, SHIVAM NARENDRA Supervising Prescribing Practitioner Medical Doctor 156160 09/08/2022

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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 4/29/2025



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** 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.


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