License Verification

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FARID ANTOINE HAKIM

License Number: ME69963

Data As Of 12/25/2024

Profession
Medical Doctor
License
ME69963
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2025
License Original Issue Date
02/15/1996
Address of Record
10475 CENTRUION PARKWAY, N
SUITE 220
JACKSONVILLE, FL 32256
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
2627 Riverside Avenue, 3rd Floor PLAZA ONE STE 608
JACKSONVILLE, FL 32204
Address
232 PONTE VEDRA PARK DRIVE
PONTE VEDRA, FL 32082
Address
15255 MAX LEGGETT PRKWY, 5TH FLOOR
JACKSONVILLE, FL 32218
Name Relationship Profession License Effective Date
ARNDT, STEPHEN ROBERT Supervisor Medical Doctor 143102 02/15/2021
PUCKETT, BRETT CHRISTOPHER Supervisor Medical Doctor 91111 08/24/2020

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Name Relationship Profession License Effective Date
FREY, KYRA MARIA Dispensing Physician Assistant Physician Assistant 9112380 7/12/2022
FREY, KYRA MARIA Prescribing Physician Assistant Physician Assistant 9112380 7/1/2022
LAUDERDALE, LOGAN SCOTT Dispensing Physician Assistant Physician Assistant 9118127 7/20/2024
LAUDERDALE, LOGAN SCOTT Prescribing Physician Assistant Physician Assistant 9118127 7/20/2024

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/25/2024



* 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.