License Verification

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KEITH TARIQ AZIZ

License Number: ME152027

Data As Of 12/2/2024

Profession
Medical Doctor
License
ME152027
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
07/25/2021
Address of Record
4500 SAN PABLO RD
Mayo Clinic - Department of Orthopedics
JACKSONVILLE, FL 32224
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
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
DAVIS, TREVAINE ANDREE' TREVOR Prescribing Physician Assistant Physician Assistant 9114150 10/3/2024
KENT, KRISTON ALLEN Prescribing Physician Assistant Physician Assistant 9112306 10/21/2024
MCMAHON, DANIEL PATRICK Prescribing Physician Assistant Physician Assistant 9107996 10/3/2024
MULVILLE, ANDREW KING Prescribing Physician Assistant Physician Assistant 9117045 10/3/2024
PETERS, CORY GRANT Prescribing Physician Assistant Physician Assistant 9106781 10/21/2024
ZUMMO, VINCENT CIRO Prescribing Physician Assistant Physician Assistant 9106504 1/24/2023

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 12/2/2024



* 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.