License Verification

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KIMBERLY LOCKWOOD FLYNN

License Number: PA9105328

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9105328
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
12/31/2009
Address of Record
2627 W. Eau Gallie BLVD
Suite 101
MELBOURNE, FL 32935
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1425 Malabar Rd. NE Palm Bay Hospital
PALM BAY, FL 32907
Address
701 W. COCOA B EACH CAUSEWAY CAPE CANAVERAL HOSPITAL
COCOA BEACH, FL 32931
Address
8745 N. Wickham RD
MELBOURNE, FL 32940
Address
8745 N. Wickham Rd.
VIERA, FL 32940
Address
701 W. Cocoa Beach Causeway
COCOA BEACH, FL 32931
Name Relationship Profession License Effective Date
ALVAREZ, COREY Supervising Prescribing Practitioner Medical Doctor 131625 09/26/2017
CHAO, MAURICE JAY Supervising Prescribing Practitioner Osteopathic Physician 8629 11/15/2018
CROSS, WILLIAM IAN Supervising Prescribing Practitioner Osteopathic Physician 10316 10/25/2022
DEVAUX, MIKAELA ELISE Supervising Prescribing Practitioner Medical Doctor 130853 09/26/2017
DEVEREAUX, DANIELLE Supervising Prescribing Practitioner Medical Doctor 129224 12/02/2016
D'ONOFRIO, KALI RAE Supervising Prescribing Practitioner Osteopathic Physician 12738 11/15/2018
DUCKWORTH, ANGELA LEEANN MD Supervising Prescribing Practitioner Medical Doctor 112929 11/15/2018
DUDLEY, LARISSA SOPHIA Supervising Prescribing Practitioner Medical Doctor 131434 09/26/2017
FLEMING, MICHAEL MD Supervising Prescribing Practitioner Medical Doctor 133576 11/15/2018
HOMERICK, MICHAEL JOHN Supervising Prescribing Practitioner Medical Doctor 119113 05/22/2017
JONES JR, PRESTON M Supervising Prescribing Practitioner Medical Doctor 162801 08/17/2023
MATHEW, DANA RICHARDS MD Supervising Prescribing Practitioner Medical Doctor 128175 05/22/2017
MCGOOHAN, MICHAEL PATRICK DO Supervising Prescribing Practitioner Osteopathic Physician 6325 11/15/2018
MILEY, STEPHEN MICHAEL Supervising Prescribing Practitioner Medical Doctor 34421 11/15/2018
MONTGOMERY, ELISHA ANNE Supervising Prescribing Practitioner Medical Doctor 122062 09/26/2017
RAMAGE, DARRON TRAVIS Supervising Prescribing Practitioner Medical Doctor 115024 08/28/2019
ROTOLO, ALYSSA BIXBY Supervising Prescribing Practitioner Medical Doctor 127035 11/15/2018
STOJANOVSKI, MIHAIL METODIJA Supervising Prescribing Practitioner Medical Doctor 130869 09/26/2017
TYMKOWICZ, ALEXANDRIA Supervising Prescribing Practitioner Medical Doctor 156308 03/14/2023
VAN HEMEL, ELIZABETH ANNE Supervising Prescribing Practitioner Physician Assistant 3575 10/25/2022
WALKER, GEORGE HAROLD MD Supervising Prescribing Practitioner Medical Doctor 70189 11/15/2018
WEBER, DOUGLAS ANTHONY Supervising Prescribing Practitioner Medical Doctor 143900 05/01/2020
WEEMAN, MITCHELL Supervising Prescribing Practitioner Medical Doctor 160791 07/26/2023
YOUNG, VICTOR CHANCE Supervising Prescribing Practitioner Osteopathic Physician 8339 06/03/2016

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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.