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License Verification

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SI MAI PHAM

License Number: ME132351

Data As Of 5/29/2024

Profession
Medical Doctor
License
ME132351
License Status
CLEAR/Active
Qualifications
Dispensing Practitioner
NICA Part. Physician (FEE)
License Expiration Date
1/31/2025
License Original Issue Date
05/03/2017
Address of Record
Mayo Clinic 4500 San Pablo Rd
JACKSONVILLE, FL 32224
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date
CHIM, AUTUMN LEE Prescribing Physician Assistant Physician Assistant 9116378 1/27/2023
COOKE, SUSAN AMANDA Prescribing Physician Assistant Physician Assistant 9103706 9/18/2023
MARCHIO, DANIELLE DAWN Prescribing Physician Assistant Physician Assistant 9108001 7/5/2017
PACIOTTI, BREAH LYNN Prescribing Physician Assistant Physician Assistant 9112425 2/20/2020
PATEL, HARDIKKUMAR Prescribing Physician Assistant Physician Assistant 9117795 12/4/2023
WILKE, JULIA A Prescribing Physician Assistant Physician Assistant 9109443 8/14/2018

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 5/29/2024



* 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.