License Verification

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ILYAS AHMED GUTALE

License Number: PA9105989

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9105989
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
05/17/2011
Address of Record
600 E DIXIE AVE
LEESBURG, FL 34748
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1451 EL CAMINO REAL THE VILLAGES REGIONAL HOSPITAL
THE VILLAGES, FL 32159
Address
1150 US Hwy 1
VERO BEACH, FL 32960
Address
313 SW Pine Island Rd
CAPE CORAL, FL 33991
Address
960 W Sugarland Hwy
CLEWISTON, FL 33440
Address
1021 N State Road 7
ROYAL PLM BEACH, FL 33411
Address
4520 Donald Ross Rd
PALM BEACH GARDENS, FL 33418
Address
1809 N University Drive
CORAL SPRINGS, FL 33071
Address
7593 Boynton Beach Blvd
BOYNTON BEACH, FL 33437
Address
19090 State Road 7
BOCA RATON, FL 33498
Address
19985 S Tamiami Trail
ESTERO, FL 33928
Address
11985 Atlantic Blvd
JACKSONVILLE, FL 32225
Address
7220 Merrill Road
JACKSONVILLE, FL 32277
Address
13005 Collier Blvd
NAPLES, FL 34116
Address
1328 N Woodland Blvd
DELAND, FL 32720
Address
220 Tamiami Trail
PORT CHARLOTTE, FL 33948
Address
5616 Tuscola Blvd
BRADENTON, FL 34281
Address
7593 Boynton Beach Blvd Suite 190
BOYNTON BEACH, FL 33437
Address
8849 State Road 52 MedExpress-Hudson
HUDSON, FL 34667
Address
12375 S Cleveland Avenue MedExpress Urgent Care-Fort Myers
FORT MYERS, FL 33907
Address
1120 Homestead Road N MedExpress Urgent Care-Lehigh Acres
LEHIGH ACRES, FL 33936
Address
10500 Ulmerton Road MedExpress Urgent Care-Largo Suite 202
LARGO, FL 33771
Address
2810 W Martin Luther King Blvd MedExpress Urgent Care-West Tampa
TAMPA, FL 33607
Address
3700 US Highway 98 N MedExpress Urgent Care-Lakeland
LAKELAND, FL 33809
Address
22945 State Road 54 MedExpress Urgent Care-Lutz
LUTZ, FL 33549
Address
13610 N Bruce B Downs Blvd MedExpress Urgent Care-Northside
TAMPA, FL 33613
Address
20677 Bruce B Downs Blvd MedExpress Urgent Care New Tampa
TAMPA, FL 33647
Address
26812 US Hwy 19 N MedExpress Urgent Care-Clearwater
CLEARWATER, FL 33761
Address
13856 N Dale Mabry MedExpress Urgent Care-Carrollwood
TAMPA, FL 33618
Address
206 E Brandon Blvd MedExpress Urgent Care-Brandon
BRANDON, FL 33511
Name Relationship Profession License Effective Date
NEZOWITZ, GREGG DAVID Supervising Dispensing Practitioner Medical Doctor 75671 06/18/2021
NEZOWITZ, GREGG DAVID Supervising Prescribing Practitioner Medical Doctor 75671 06/16/2021

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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.