License Verification

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MARTIN ANTONY FIDELIA

License Number: PA9105354

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9105354
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/12/2010
Address of Record
1800 SE Tiffany Ave
PORT SAINT LUCIE, FL 34952
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
7710 US Hwy 7710 US HIGHWAY 1 PORT SAINT LUCIE
PORT SAINT LUCIE, FL 34952
Name Relationship Profession License Effective Date
FORD, ROBERT CHARLES III Supervising Prescribing Practitioner Osteopathic Physician 12456 03/14/2016
GAGEN, JAMES SHAWN Supervising Prescribing Practitioner Osteopathic Physician 10263 03/14/2016
MCPHERSON, JOHN RAMEY Supervising Prescribing Practitioner Medical Doctor 58708 03/14/2016

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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.