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KIMBERLY MILLIGAN SHAPIRO

License Number: PA9106846

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9106846
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
09/18/2012
Address of Record
461 SO NOVA ROAD
ORMOND BEACH, FL 32174
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
239 N. RIDGEWOOD AVE.
EDGEWATER, FL 32132
Address
740 DUNLAWTON AVE.
PORT ORANGE, FL 32127
Address
350 NORTH CLYDE MORRIS BLVD.
DAYTONA BEACH, FL 32114
Address
2777 ENTERPRISE RD.
ORANGE CITY, FL 32763
Address
937 N. SPRING GARDENS AVE.
DELAND, FL 32720
Address
461 S. NOVA RD.
ORMOND BEACH, FL 32174
Name Relationship Profession License Effective Date
LE, ELIZABETH ANN Supervising Prescribing Practitioner Medical Doctor 99663 02/06/2019
MATHEW, SUSAN P Supervising Prescribing Practitioner Medical Doctor 102982 02/15/2019
NIPPER, NEIL BAKER MD Supervising Prescribing Practitioner Medical Doctor 108608 01/26/2016
ROSATI, SAMUEL M Supervising Prescribing Practitioner Medical Doctor 103357 02/06/2019

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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.