License Verification

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SHERRI MADRID ANDERSON

License Number: PA9105823

Data As Of 5/17/2024

Profession
Physician Assistant
License
PA9105823
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
12/02/2010
Address of Record
1775 W. HIBISCUS BLVD
SUITE 215
MELBOURNE, FL 32901
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1350 S. Hickory Street Holmes Regional Medical Center
MELBOURNE, FL 32901
Address
1425 Malabar Road NE Palm Bay Hospital
PALM BAY, FL 32907
Name Relationship Profession License Effective Date
AGOSTO DIAZ, EDIL J Supervising Prescribing Practitioner Medical Doctor 102761 10/26/2022
BANAPOOR, BENJAMIN Supervising Prescribing Practitioner Medical Doctor 156442 10/25/2022
BRONSTEMA, CLARENCE JAMES DO Supervising Prescribing Practitioner Osteopathic Physician 9722 10/25/2022
BROWN, MARTY RAY M D Supervising Prescribing Practitioner Medical Doctor 75648 10/25/2023
PIRAZZI-MARQUEZ, BEATRIZ M Supervising Prescribing Practitioner Medical Doctor 102083 04/20/2023
REHAK, CHRISTOPHER STEPHEN Supervising Prescribing Practitioner Medical Doctor 78080 10/25/2022
ST CLAIR, AARON LEE Supervising Prescribing Practitioner Medical Doctor 106075 06/26/2023
VAZQUEZ, JOHNNY J Supervising Prescribing Practitioner Medical Doctor 97644 10/25/2022

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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 5/17/2024



* 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.


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