License Verification

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TIFFANY MOMOKO SPARROW

License Number: PA9116575

Data As Of 12/4/2024

Profession
Physician Assistant
License
PA9116575
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/29/2022
Address of Record
915 W Monroe Street
Suite 200
JACKSONVILLE, FL 32204
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
AYAD, SALWA SALAMA MD Supervising Prescribing Practitioner Medical Doctor 94569 06/03/2024
HICKMAN, HOLLIE JO Supervising Prescribing Practitioner Osteopathic Physician 9337 11/11/2022
KAMBHATLA, AKSHAYA Supervising Prescribing Practitioner Medical Doctor 167071 07/09/2024
SHRESTHA, ANIL PRASAD MD Supervising Prescribing Practitioner Medical Doctor 83286 06/03/2024
VILLAVICENCIO, RAQUEL Supervising Prescribing Practitioner Medical Doctor 166674 07/22/2024
WARDA, FIRAS Supervising Prescribing Practitioner Medical Doctor 155506 06/03/2024

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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 12/4/2024



* 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.