License Verification

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MIGUEL A FANA JR

License Number: ME80639

Data As Of 12/3/2024

Profession
Medical Doctor
License
ME80639
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
06/27/2000
Address of Record
5798 38th Avenue North
ST. PETERSBURG, FL 33710
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
13220 BELCHER RD S UNIT 15
LARGO, FL 33773
Address
300 76th Ave
ST PETERSBURG BEACH, FL 33706
Address
1111 7th Avenue North Ste 107
SAINT PETERSBURG, FL 33705
Address
2626 Tampa Rd, Suite 104
PALM HARBOR, FL 34684-3110
Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
ROSA, BRIAN MATTHEW Dispensing Physician Assistant Physician Assistant 9108708 11/26/2019
ROSA, BRIAN MATTHEW Prescribing Physician Assistant Physician Assistant 9108708 11/26/2019

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/3/2024



* 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.