License Verification

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BEVIN AMEZCUA

License Number: PA9120536

Data As Of 12/14/2025

Profession
Physician Assistant
License
PA9120536
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2028
License Original Issue Date
08/01/2025
Address of Record
Mayo Clinic
4500 San Pablo Road
JACKSONVILLE, FL 32224
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
HARNOIS, DENISE MARIE Supervising Prescribing Practitioner Osteopathic Physician 7819 11/20/2025
KEAVENY, ANDREW PAUL Supervising Prescribing Practitioner Medical Doctor 88153 11/03/2025
LOO, NICOLE MING-MING Supervising Prescribing Practitioner Medical Doctor 150435 11/03/2025
MOUSA, OMAR YOUSEF SULAI Supervising Prescribing Practitioner Medical Doctor 172853 11/03/2025
PATEL, TUSHAR CHANDRAKANT Supervising Prescribing Practitioner Medical Doctor 108804 11/06/2025
PUNGPAPONG, SURAKIT Supervising Prescribing Practitioner Medical Doctor 87415 11/06/2025
ROSSER, BARRY GRIFFITH Supervising Prescribing Practitioner Medical Doctor 85590 11/06/2025
SATYANARAYANA, RAJ Supervising Prescribing Practitioner Medical Doctor 84054 11/13/2025
YANG, LIU Supervising Prescribing Practitioner Medical Doctor 125186 11/03/2025
YATACO, MARIA LUISA Supervising Prescribing Practitioner Medical Doctor 83710 11/06/2025

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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 12/14/2025



* 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.