License Verification

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ALLISON REBECCA BURGESS PA-C

License Number: PA9108894

Data As Of 11/21/2024

Profession
Physician Assistant
License
PA9108894
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
08/25/2015
Address of Record
1011 Jeffords Street
Suite D
FMSG- ORTHOPAEDIC SPECIALTIES OF TAMPA
CLEARWATER, FL 33756
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
711 S Belcher Rd BayCare Medical Group Baycare Urgent Care
CLEARWATER, FL 33764
Address
3503 East Frontage Road BayCare Medical Group Telemedicine Program
TAMPA, FL 33607
Address
1011 JEFFORDS ST. STE#D FMSG- ORTHOPAEDIC SPECIALTIES OF TAMPA Suite D
CLEARWATER, FL 33756
Name Relationship Profession License Effective Date
PIAZZA, MICHAEL ROBERT MD Supervising Prescribing Practitioner Medical Doctor 54690 03/28/2017
SMITH, JAMES MICHAEL Supervising Prescribing Practitioner Medical Doctor 106958 11/09/2018
WALDREP, NATHAN KEITH Supervising Dispensing Practitioner Medical Doctor 58834 11/27/2023
WALDREP, NATHAN KEITH Supervising Prescribing Practitioner Medical Doctor 58834 04/25/2020

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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 11/21/2024



* 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.