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MARCELO JOSE LACAYO BAEZ

License Number: ME140238

Data As Of 9/7/2026

Profession
Medical Doctor
License
ME140238
License Status
Clear/Active
License Expiration Date
1/31/2027
License Original Issue Date
04/10/2019
Address of Record
400 N. STATE OF FRANKLIN RD.
Pediatric Emergency Department
JOHNSON CITY, TN 37604
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

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Name Relationship Profession License Effective Date
BARNES, RICHARD R JR Prescribing Physician Assistant Medical Doctor 69285 6/27/2024
BISTER, MARY KATHLEEN Prescribing Physician Assistant Medical Doctor 156254 11/15/2024
CEPELAK, CARLY MICHELLE Prescribing Physician Assistant Physician Assistant 9119869 11/11/2025
CRAWFORD, PERRY WILLIAM Prescribing Physician Assistant Physician Assistant 9113494 8/11/2023
DAWKINS, DONALD Prescribing Physician Assistant Osteopathic Physician 10160 10/19/2023
DIEHL, NATHAN JEROLD Prescribing Physician Assistant Physician Assistant 9113328 3/21/2023
EVANGELISTI, MINDY Prescribing Physician Assistant Physician Assistant 9118901 7/9/2024
FASIUDDIN, NAJAM Prescribing Physician Assistant Osteopathic Physician 15006 1/10/2023
HAMPTON, WESTON WAYNE Prescribing Physician Assistant Medical Doctor 157622 1/1/2025
KIRBY, SARA E Prescribing Physician Assistant Medical Doctor 113449 2/1/2023
MONROE, BRADLEY SEAN Prescribing Physician Assistant Physician Assistant 9115248 1/10/2023
NICHOLS, ALEXANDER CARL Prescribing Physician Assistant Physician Assistant 9117561 7/12/2023
PENA, TIFFANY TATIANA Prescribing Physician Assistant Physician Assistant 9109748 12/30/2025
SCHLEIF, ROBERT DAVID Prescribing Physician Assistant Physician Assistant 9112559 9/26/2022
SCOTT, DAVID Prescribing Physician Assistant Medical Doctor 143679 10/28/2025
SMIT, MARIA VALENTI Prescribing Physician Assistant Physician Assistant 9105510 10/28/2025
SMITH, ALLISTAIR Prescribing Physician Assistant Physician Assistant 9111535 11/20/2022

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 9/7/2026



* 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.