License Verification

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JUDITH R MACNICHOLS

License Number: PA3264

Data As Of 10/9/2025

Profession
Physician Assistant
License
PA3264
License Status
Null And Void/
Qualifications
Prescribing
License Expiration Date
1/31/2022
License Original Issue Date
01/14/1997
Address of Record
If further information is needed, please contact the Department of Health at (850) 488-0595.
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
929 N. SPRING GARDEN AVE, STE. 170 BLANCA LUNA, MD,PA
DELAND, FL 32720
Address
MEMORIAL FAMILY CARE:DELEON SP 4820 HIGHWAY 17 NORTH
DE LEON SPRINGS, FL 32130
Address
999 N. STONE STREET SUITE B
DELAND, FL 32720
Address
1671 N CLYDE MOM'S BLVD, STE A
DAYTONA BEACH, FL 32117
Address
8813 River Crossing Blvd Path Medical New Port Richey
NEW PORT RICHEY, FL 34655
Address
4700 North Habana Ave, Ste 100 Path Medical Central Tampa
TAMPA, FL 33614
Address
809 South Florida Avenue Path Medical Lakeland
LAKELAND, FL 33801
Address
6060 26th Street West Path Medical Bradenton
BRADENTON, FL 34207
Address
14824 North Florida Ave, Ste A Path Medical North Tampa
TAMPA, FL 33613
Address
3140 34th Street North Path Medical St Pete
SAINT PETERSBURG, FL 33713
Name Relationship Profession License Effective Date

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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 10/9/2025



* 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.