License Verification

Printer Friendly Version

CLARENCE RICHARD GRAVES III

License Number: PA9106480

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9106480
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
03/20/2012
Address of Record
2150 SE Salerno Rd Ste 110
CLEVELAND CLINIC MARTIN HEALTH
ORTHOPEDIC SURGERY DEPARTMENT
STUART, FL 34997
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
200 Hospital Ave Martin Memorial Medical Center North
STUART, FL 34994
Address
2100 SE Salerno Rd. CLEVELAND CLINIC MARTIN HEALTH SOUTH
STUART, FL 34997
Address
10050 SW INNOVATION WAY MANN 1, STE. 201 CLEVELAND CLINIC TRADITION MEDICAL CTR
PORT SAINT LUCIE, FL 34987
Address
10000 INNOVATION WAY CLEVELAND CLINIC TRADITION MEDICAL CTR
PORT SAINT LUCIE, FL 34987
Address
1095 NW SAINT LUCIE WEST BLVD MARTIN MEDICAL CENTER AT ST. LUCIE WEST
PORT SAINT LUCIE, FL 34986
Address
2100 SE Salerno Rd
STUART, FL 34997
Address
1095 St. Lucie West Blvd
PORT SAINT LUCIE, FL 34986
Address
10000 SW Innovation Way
PORT SAINT LUCIE, FL 34987
Address
200 SE Hospital Ave CLEVELAND CLINIC MARTIN HEALTH SOUTH HOSPITAL
STUART, FL 34994
Name Relationship Profession License Effective Date
ANAGO, KOSISOCHUKWU NKENNA Supervising Prescribing Practitioner Medical Doctor 137136 04/29/2019
BIGLIONE, ALEJANDRO GUSTAVO MD Supervising Prescribing Practitioner Medical Doctor 78592 04/29/2019
CASAS-REYES, CARLOS EDUARDO Supervising Prescribing Practitioner Medical Doctor 113039 11/26/2019
DELAHAY, JOHN NORRIS Supervising Prescribing Practitioner Medical Doctor 137975 08/01/2021
EVANS, PETER JOHN Supervising Prescribing Practitioner Medical Doctor 143787 08/01/2021
FOWBLE, VINCENT ALLEN Supervising Prescribing Practitioner Medical Doctor 94144 08/01/2021
HOU, KEVIN Supervising Prescribing Practitioner Medical Doctor 135279 04/30/2019
MASOOD, ASIF Supervising Prescribing Practitioner Medical Doctor 100913 03/16/2019
MILLER, JEFFREY WILLIAM Supervising Prescribing Practitioner Medical Doctor 136475 05/05/2020
PATEL, SHERI M D Supervising Prescribing Practitioner Medical Doctor 131428 04/30/2019
REYES, ANDRES M Supervising Prescribing Practitioner Medical Doctor 100755 04/30/2019
ROSKI, RICHARD ARTHUR MD Supervising Prescribing Practitioner Medical Doctor 103866 11/26/2019
SPINDLER, KURT P Supervising Prescribing Practitioner Medical Doctor 148995 08/01/2021
THUMMA, VIJAY BHASKER REDDY Supervising Prescribing Practitioner Medical Doctor 135589 04/30/2019
VILLANUEVA, HAZEL HONEYLET REDUAL Supervising Prescribing Practitioner Medical Doctor 142922 05/07/2020

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



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.