License Verification

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SUSELY CAROLINA RODRIGUEZ

License Number: PA9115448

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9115448
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/03/2022
Address of Record
2627 W Eau Gallie Blvd
Suite 101
MELBOURNE, FL 32935
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
AGOSTO DIAZ, EDIL J Supervising Prescribing Practitioner Medical Doctor 102761 10/06/2022
BANAPOOR, BENJAMIN Supervising Prescribing Practitioner Medical Doctor 156442 10/06/2022
BRONSTEMA, CLARENCE JAMES DO Supervising Prescribing Practitioner Osteopathic Physician 9722 10/06/2022
BROWN, MARTY RAY M D Supervising Prescribing Practitioner Medical Doctor 75648 10/06/2022
DEVEREAUX, DANIELLE Supervising Prescribing Practitioner Medical Doctor 129224 10/06/2022
FOSTER, QUINTON ADAM Supervising Prescribing Practitioner Medical Doctor 168147 08/14/2024
GUTTA, RAJESH Supervising Prescribing Practitioner Medical Doctor 82886 10/06/2022
HOMERICK, MICHAEL JOHN Supervising Prescribing Practitioner Medical Doctor 119113 10/06/2022
JOCKOVICH, MILAN MD Supervising Prescribing Practitioner Medical Doctor 65559 10/06/2022
JONES JR, PRESTON M Supervising Prescribing Practitioner Medical Doctor 162801 08/17/2023
LENOCI, ROBERT Supervising Prescribing Practitioner Medical Doctor 156047 10/06/2022
MATHEW, DANA RICHARDS MD Supervising Prescribing Practitioner Medical Doctor 128175 10/06/2022
MILES, JAMES TIMOTHY Supervising Prescribing Practitioner Medical Doctor 76017 10/06/2022
PIRAZZI-MARQUEZ, BEATRIZ M Supervising Prescribing Practitioner Medical Doctor 102083 10/06/2022
ROTOLO, ALYSSA BIXBY Supervising Prescribing Practitioner Medical Doctor 127035 10/06/2022
ST CLAIR, AARON LEE Supervising Prescribing Practitioner Medical Doctor 106075 10/03/2022
STOJANOVSKI, MIHAIL METODIJA Supervising Prescribing Practitioner Medical Doctor 130869 10/06/2022
TYMKOWICZ, ALEXANDRIA Supervising Prescribing Practitioner Medical Doctor 156308 03/14/2023
VAZQUEZ, JOHNNY J Supervising Prescribing Practitioner Medical Doctor 97644 10/04/2022
WEEMAN, MITCHELL Supervising Prescribing Practitioner Medical Doctor 160791 07/26/2023
YOUNG, VICTOR CHANCE Supervising Prescribing Practitioner Osteopathic Physician 8339 10/06/2022

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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 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.