License Verification

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SHAWN ERIC LEIBA

License Number: PA9102969

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9102969
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/21/2004
Address of Record
7800 SHERIDAN STREET
MEMORIAL HOSPITAL PEMBROKE
PEMBROKE PINES, FL 33024
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
801 S. DOUGLAS ROAD MEMORIAL HOSPITAL PEMBROKE URGENT CARE
PEMBROKE PINES, FL 33025
Address
3501 Johnson Street
HOLLYWOOD, FL 33021
Address
3600 Washington Street
HOLLYWOOD, FL 33021
Name Relationship Profession License Effective Date
ESTREICHER, MICHAEL BENJAMIN Supervising Prescribing Practitioner Medical Doctor 115512 08/07/2017
FEINSTEIN, STACEY MICHELLE Supervising Prescribing Practitioner Osteopathic Physician 13763 08/08/2017
FERNANDEZ, MANUEL Supervising Prescribing Practitioner Medical Doctor 85860 08/08/2017
LISIEWSKI, ASHLEY LYNN Supervising Prescribing Practitioner Osteopathic Physician 13246 08/08/2017
PITTS, DAPHNE MARIAN MD Supervising Prescribing Practitioner Medical Doctor 90371 08/07/2017
ROSENBLAT, BOAZ SHMUEL Supervising Prescribing Practitioner Medical Doctor 84594 10/09/2023
VELOZ, WILLIAM OMAR Supervising Prescribing Practitioner Medical Doctor 112443 08/07/2017

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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.