License Verification

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DENNIS FERNANDO DIAZ

License Number: ME107205

Data As Of 12/2/2024

Profession
Medical Doctor
License
ME107205
License Status
CLEAR/Active
License Expiration Date
1/31/2026
License Original Issue Date
05/20/2010
Address of Record
2864 Wellness Ave
SUITE 200
ORANGE CITY, FL 32763
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
CUMBERBATCH, GREGORY ALVIN Supervisor Medical Doctor 117465 06/09/2021

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Name Relationship Profession License Effective Date
NGUYEN, KHANH QUANG Prescribing Physician Assistant Physician Assistant 9102312 2/8/2018
VAN DYKE, TRAVIS BOYD Subordinate Medical Doctor 92680 2/1/2018
WIESE, JON DICK MD Subordinate Medical Doctor 54060 2/8/2018

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



* 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.