License Verification

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MERCEDES MALONE

License Number: ME166015

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME166015
License Status
CLEAR/Active
Qualifications
In Training Program Receives Fee Reducti
License Expiration Date
1/31/2026
License Original Issue Date
12/11/2023
Address of Record
917 Shoreline Circle
PONTE VEDRA, FL 32082
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

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Name Relationship Profession License Effective Date
BURDEN, CHARITY Prescribing Physician Assistant Physician Assistant 9117433 6/5/2024
CANTOR, LUIS Prescribing Physician Assistant Physician Assistant 9113587 5/8/2024
CHEN, AMY Prescribing Physician Assistant Physician Assistant 9115760 5/8/2024
DIENELL, KATIE Prescribing Physician Assistant Physician Assistant 9117206 5/8/2024
KHAN, FARIHAH Prescribing Physician Assistant Physician Assistant 9111876 5/8/2024
KIMBLE, TIFFANY ANNE Prescribing Physician Assistant Physician Assistant 9105875 5/8/2024
KORNETTI, BRIANNE NICOLE Prescribing Physician Assistant Physician Assistant 9118683 5/8/2024
PERICLES, ADALYNE Prescribing Physician Assistant Physician Assistant 9107848 5/30/2024
PUTMAN, LESLIE SUE Prescribing Physician Assistant Physician Assistant 3042 5/8/2024
RAZZAQ, MARIA Prescribing Physician Assistant Physician Assistant 9111979 5/8/2024
SHAFII, LATIFEH Prescribing Physician Assistant Physician Assistant 9112064 5/8/2024
STEWART, MONIQUE ELIZABETH Prescribing Physician Assistant Physician Assistant 9110267 7/25/2024
UMANSKY, BETH LAUREN Prescribing Physician Assistant Physician Assistant 9107407 5/8/2024
VAN FOSSEN, JAMES WILLIAM Prescribing Physician Assistant Physician Assistant 9118780 6/12/2024
VIGROUX, BETHANY NICOLE Prescribing Physician Assistant Physician Assistant 9107323 5/8/2024

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

Name Relationship Profession License Effective Date

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



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.