License Verification

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ELIJAH GORDON WELLS

License Number: PA9113266

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9113266
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
06/09/2020
Address of Record
2627 West Eau Gaille Blvd.
Suite 101
MELBOURNE, FL 32935
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
5811 Williamson Blvd Advent Health Port Orange
PT ORANGE, FL 32128
Address
1055 Saxon Blvd Advent Health Fish Memorial
ORANGE CITY, FL 32763
Address
301 Memorial Medical Parkway Advent Health Daytona Beach
DAYTONA BEACH, FL 32117
Address
401 Palmetto Street Advent Health New Smyrna
NEW SMYRNA BEACH, FL 32168
Address
701 W Plymouth St Advent Health Deland
ORMOND BEACH, FL 32174
Name Relationship Profession License Effective Date
BRONSTEMA, CLARENCE JAMES DO Supervising Prescribing Practitioner Osteopathic Physician 9722 03/30/2023
BROWN, MARTY RAY M D Supervising Prescribing Practitioner Medical Doctor 75648 03/30/2023
CSORTAN, ERIC STEVEN Supervising Prescribing Practitioner Medical Doctor 84708 03/30/2023
DEVEREAUX, DANIELLE Supervising Prescribing Practitioner Medical Doctor 129224 03/30/2023
DUDLEY, LARISSA SOPHIA Supervising Prescribing Practitioner Medical Doctor 131434 03/30/2023
FOSTER, QUINTON ADAM Supervising Prescribing Practitioner Medical Doctor 168147 08/14/2024
GAGEN, JAMES SHAWN Supervising Prescribing Practitioner Osteopathic Physician 10263 03/30/2023
GREEN, DOUGLAS WARREN MD Supervising Prescribing Practitioner Medical Doctor 81481 03/30/2023
GRIFFIN, JOHN PATRICK MD Supervising Prescribing Practitioner Medical Doctor 78523 03/30/2023
GUTTA, RAJESH Supervising Prescribing Practitioner Medical Doctor 82886 03/30/2023
HOMERICK, MICHAEL JOHN Supervising Prescribing Practitioner Medical Doctor 119113 03/30/2023
JOCKOVICH, MILAN MD Supervising Prescribing Practitioner Medical Doctor 65559 03/30/2023
JONES JR, PRESTON M Supervising Prescribing Practitioner Medical Doctor 162801 08/17/2023
LENOCI, ROBERT Supervising Prescribing Practitioner Medical Doctor 156047 03/30/2023
LIVINGSTON, ROBERT TERENCE Supervising Prescribing Practitioner Medical Doctor 83159 06/01/2021
LLINAS, JACQUELINE B MD Supervising Prescribing Practitioner Medical Doctor 68727 03/30/2023
MATHEW, DANA RICHARDS MD Supervising Prescribing Practitioner Medical Doctor 128175 03/30/2023
MCNAMEE, JUSTIN JAMES Supervising Prescribing Practitioner Osteopathic Physician 12888 06/01/2021
MILES, JAMES TIMOTHY Supervising Prescribing Practitioner Medical Doctor 76017 03/30/2023
MOSES, DUSTY ALLEN DR Supervising Prescribing Practitioner Medical Doctor 115932 06/14/2021
MUCCIOLO, PAUL MD Supervising Prescribing Practitioner Medical Doctor 69281 06/04/2021
OLIVEIRA, BRIAN MARIO Supervising Prescribing Practitioner Medical Doctor 110586 03/30/2023
OSWALD, NED ANTHONY MD Supervising Prescribing Practitioner Medical Doctor 121076 03/30/2023
PIRAZZI-MARQUEZ, BEATRIZ M Supervising Prescribing Practitioner Medical Doctor 102083 03/30/2023
RAMIA, MICHELLE MARIE Supervising Prescribing Practitioner Medical Doctor 116871 06/06/2021
ROTOLO, ALYSSA BIXBY Supervising Prescribing Practitioner Medical Doctor 127035 03/30/2023
SISKO, MATTHEW DAVID Supervising Prescribing Practitioner Medical Doctor 111919 06/02/2021
ST CLAIR, AARON LEE Supervising Prescribing Practitioner Medical Doctor 106075 03/30/2023
STOJANOVSKI, MIHAIL METODIJA Supervising Prescribing Practitioner Medical Doctor 130869 03/30/2023
TYMKOWICZ, ALEXANDRIA Supervising Prescribing Practitioner Medical Doctor 156308 03/14/2023
VAZQUEZ, JOHNNY J Supervising Prescribing Practitioner Medical Doctor 97644 03/30/2023
WEBER, DOUGLAS ANTHONY Supervising Prescribing Practitioner Medical Doctor 143900 03/30/2023
WEEMAN, MITCHELL Supervising Prescribing Practitioner Medical Doctor 160791 07/26/2023
WEINER, TRACY I DO Supervising Prescribing Practitioner Osteopathic Physician 7471 06/02/2021

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Name Relationship Profession License Effective Date

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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.