License Verification

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FREDDY ALEJANDRO MORENO

License Number: PA9113159

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9113159
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
04/13/2020
Address of Record
730 Malabar Rd, Ste. C
MALABAR, FL 32950-3140
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
8725 N Wickham Road Suite 301
MELBOURNE, FL 32940-2240
Name Relationship Profession License Effective Date
FOSTER, BROCK Supervising Prescribing Practitioner Medical Doctor 153253 09/16/2024
SEGINA, DANIEL NICK MD Supervising Prescribing Practitioner Medical Doctor 78748 09/16/2024
WILLIAMS, DAVID THOMAS Supervising Dispensing Practitioner Osteopathic Physician 6588 08/13/2020
WILLIAMS, DAVID THOMAS Supervising Prescribing Practitioner Osteopathic Physician 6588 04/15/2020

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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 12/23/2024



* 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.