License Verification

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TRAVIS BOYD VAN DYKE

License Number: ME92680

Data As Of 12/23/2024

Profession
Medical Doctor
License
ME92680
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
License Expiration Date
1/31/2025
License Original Issue Date
02/18/2005
Address of Record
25 W. CRYSTAL LAKE STREET STE
ORLANDO, FL 32806
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
7350 SANDLAKE COMMONS BLVD STE 3315
ORLANDO, FL 32819
Address
9685 LAKE NONA VILLAGE PL STE 102
ORLANDO, FL 32827
Address
6424 ALEXANDRA LOUISE DRIVE STE. 200
ORLANDO, FL 32827
Name Relationship Profession License Effective Date
ADIGWEME, OBINNA Supervisor Medical Doctor 133150 02/01/2018
BRYANT, CHRISTOPHER SCOTT MD Supervisor Medical Doctor 122592 02/01/2018
CASTILLO, EMERITA RAFAELA Supervisor Medical Doctor 113043 02/01/2018
CHUDGAR, PRANAV BIPIN Supervisor Medical Doctor 110738 02/01/2018
DAVIS, ROBERT DUANE Supervisor Medical Doctor 124015 02/10/2018
DIAZ, DENNIS FERNANDO Supervisor Medical Doctor 107205 02/01/2018
EMTAGE, JUSTIN BRUCE Supervisor Medical Doctor 133329 02/01/2018
FREELAND, MICHAEL BAIN MD Supervisor Medical Doctor 104691 03/26/2019
HENRY, ROSANNE MARIE Supervisor Medical Doctor 127424 02/01/2018
JOHNSON, MEGAN LEE Supervisor Medical Doctor 119250 02/01/2018
MCCRAY, DEVINA KOMALAWATI SIREGAR Supervisor Medical Doctor 107029 02/01/2018
MCELVEEN, TIMOTHY STEVE Supervisor Medical Doctor 133294 02/01/2018
NOWICKI, KEVIN DONALD Supervisor Medical Doctor 62806 02/01/2018
OLOUFA, SHEREEN IBRAHIM Supervisor Medical Doctor 84000 02/10/2018
OSHODI, TEMITOPE ABIOLA Supervisor Medical Doctor 123887 02/01/2018
PATEL, PRIYA Supervisor Medical Doctor 127186 02/01/2018
RONDON VERENZUELA, LUISANGEL Supervisor Medical Doctor 134642 02/01/2018
SENSOR, STACEY LORRAINE Supervisor Osteopathic Physician 13177 02/01/2018
SILVESTRY, SCOTT CHRISTOPHER Supervisor Medical Doctor 122648 02/10/2018
VARGAS ABELLO, LINA MARIA Supervisor Medical Doctor 126900 02/01/2018

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Name Relationship Profession License Effective Date
BEHRMANN, DONALD LEE Subordinate Medical Doctor 64819 8/1/2017
HERNANDEZ, JULIO A Dispensing Physician Assistant Physician Assistant 9111074 2/15/2018
HERNANDEZ, JULIO A Prescribing Physician Assistant Physician Assistant 9111074 2/15/2018

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/23/2024



* 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.