License Verification

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MICHAEL PAUL NUCCIO

License Number: PA9102042

Data As Of 12/4/2024

Profession
Physician Assistant
License
PA9102042
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/09/2002
Address of Record
3051 6th Street
MARIANNA, FL 32446
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
3334 Capital Medical Blvd. Ste. 400
TALLAHASSEE, FL 32308
Name Relationship Profession License Effective Date
HUTCHINSON, HANK LAWRENCE Supervising Prescribing Practitioner Medical Doctor 94962 02/28/2017
LEE, MATTHEW CHRISTOPHER Supervising Prescribing Practitioner Medical Doctor 112458 02/28/2017
ROLLE, GARRISON ANTHONY Supervising Dispensing Practitioner Medical Doctor 68918 05/20/2024
ROLLE, GARRISON ANTHONY Supervising Prescribing Practitioner Medical Doctor 68918 02/28/2017
STEPHENS, WILLIAM BRADFORD III Supervising Prescribing Practitioner Medical Doctor 100799 02/28/2017

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Name Relationship Profession License Effective Date
MARIANNA ORTHOPEDIC CLINIC AND SPORTS ME HCCE Health Care Clinic Establishment Permit 2137 1/8/2009

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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.


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