License Verification

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NAJAM FASIUDDIN

License Number: OS15006

Data As Of 11/21/2024

Profession
Osteopathic Physician
License
OS15006
License Status
CLEAR/Active
License Expiration Date
3/31/2026
License Original Issue Date
11/22/2017
Address of Record
7171 N Dale Mabry Highway
AdventHealth Carrollwood Hospital
Emergency Department
TAMPA, FL 33614
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
FORTSON, SEAN JAMISON Supervising Prescribing Practitioner Osteopathic Physician 8702 07/14/2023
FRANCIS, JEFFREY Supervising Prescribing Practitioner Medical Doctor 155906 07/14/2023
FUCARINO, MATTHEW DANIEL Supervising Prescribing Practitioner Medical Doctor 110000 01/10/2023
GARCIA-GONZALEZ, ALEXANDER Supervising Prescribing Practitioner Medical Doctor 109637 07/14/2023
GONZALEZ, JAVIER IGNACIO Supervising Prescribing Practitioner Medical Doctor 107827 07/14/2023
GRANT-LEVY, TATIA R DO Supervising Prescribing Practitioner Osteopathic Physician 7331 01/10/2023
HANNA, RAAFAT MICHEL Supervising Prescribing Practitioner Medical Doctor 69412 01/10/2023
HART, CALEN GENE Supervising Prescribing Practitioner Medical Doctor 156116 01/10/2023
HASKINS, KERRY HUGH MD Supervising Prescribing Practitioner Medical Doctor 49468 01/10/2023
HATHCOCK, AMBER MARIE Supervising Prescribing Practitioner Medical Doctor 152148 07/14/2023
HLAVATY, HALEY DANIELLE Supervising Prescribing Practitioner Osteopathic Physician 16836 01/10/2023
HUGHES, MICHAEL Supervising Prescribing Practitioner Medical Doctor 156138 01/10/2023
HUME, ERIK TIMOTHY DO Supervising Prescribing Practitioner Osteopathic Physician 17391 07/14/2023
HUMMEL, LAURA Supervising Prescribing Practitioner Medical Doctor 127881 01/10/2023
HUND, JONATHAN Supervising Prescribing Practitioner Medical Doctor 162983 07/14/2023
IORIO, DOMINIC STEPHEN Supervising Prescribing Practitioner Medical Doctor 155302 07/14/2023
JEAN-FRANCOIS, JULIEN Supervising Prescribing Practitioner Medical Doctor 145041 01/10/2023
JUARBE, MARIFEL Supervising Prescribing Practitioner Medical Doctor 96542 01/10/2023
KARAGEORGIADIS, ALEXANDER STEVEN Supervising Prescribing Practitioner Medical Doctor 136223 01/10/2023
KING, ROBYN Supervising Prescribing Practitioner Osteopathic Physician 15023 01/10/2023
KIRBY, SARA E Supervising Prescribing Practitioner Medical Doctor 113449 01/10/2023
KIRTZ, JEREMY FECHTER Supervising Prescribing Practitioner Medical Doctor 108993 07/14/2023
KUMAR, DAVID RAJENDRA Supervising Prescribing Practitioner Medical Doctor 159475 07/14/2023
LACAYO BAEZ, MARCELO JOSE Supervising Prescribing Practitioner Medical Doctor 140238 01/10/2023
LALLY, ARLEEN ANN Supervising Prescribing Practitioner Osteopathic Physician 8845 01/10/2023
LAMBIE, NATALIE DAWN Supervising Prescribing Practitioner Osteopathic Physician 11732 07/14/2023
LAMEE, ALEXANDER Supervising Prescribing Practitioner Osteopathic Physician 17580 01/10/2023
LANCASTER, CHRISTINE BARONE Supervising Prescribing Practitioner Medical Doctor 95506 01/10/2023
LAND, LARRY LEE Supervising Prescribing Practitioner Medical Doctor 108914 01/10/2023
LEBLANC, LOUIS JOSEPH Supervising Prescribing Practitioner Medical Doctor 116958 01/10/2023
LEE, EUGENE C Supervising Prescribing Practitioner Medical Doctor 115521 01/10/2023
LISANKIE, MATTHEW JOSEPH II Supervising Prescribing Practitioner Medical Doctor 132249 07/14/2023
LOYD, ANNA MAE Supervising Prescribing Practitioner Osteopathic Physician 12492 07/14/2023
MADAR, MERCI GRACE Supervising Prescribing Practitioner Medical Doctor 117554 07/14/2023
MALAGON, BRITTANY FAYE Supervising Prescribing Practitioner Medical Doctor 140228 07/14/2023
RODRIGUEZ MARTIRENA, ALFREDO Supervising Prescribing Practitioner Medical Doctor 56111 07/14/2023

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Name Relationship Profession License Effective Date
ABBOTT, SHERYL LYNN Prescribing Physician Assistant Physician Assistant 9116106 2/1/2023
BARQUIN, JOSE MIGUEL JR Prescribing Physician Assistant Medical Doctor 131689 6/27/2024
BEAUCHAMP, STEFANIE Prescribing Physician Assistant Physician Assistant 9115527 11/1/2023
BOLTON, ASHLEY MARIE Prescribing Physician Assistant Physician Assistant 9108069 3/21/2023
BOWMAN, RYAN SCOTT Prescribing Physician Assistant Physician Assistant 9117823 9/12/2023
BREEN, JENA LYNN Prescribing Physician Assistant Physician Assistant 9108857 11/1/2023
CHRISTIANO, DANIELLE MARIE Subordinate Medical Doctor 98327 4/1/2018
CLINE, JESSICA MARIE LYNN Prescribing Physician Assistant Physician Assistant 9116036 10/20/2023
CRAMER, GREGORY ROBERT Prescribing Physician Assistant Physician Assistant 9116628 1/9/2023
CRAWFORD, PERRY WILLIAM Prescribing Physician Assistant Physician Assistant 9113494 8/11/2023
DEGROAT, JONATHAN THOMAS Prescribing Physician Assistant Medical Doctor 114356 7/28/2023
DEMARSE, WILLIAM ROBEY III Prescribing Physician Assistant Physician Assistant 9101285 1/10/2023
DIEHL, NATHAN JEROLD Prescribing Physician Assistant Physician Assistant 9113328 3/21/2023
DOLAN, NICHOLAS ALEXANDER Prescribing Physician Assistant Physician Assistant 9113623 2/16/2023
EVANGELISTI, MINDY Prescribing Physician Assistant Physician Assistant 9118901 7/9/2024
FELDMAN, TRAVIS SCOTT Prescribing Physician Assistant Physician Assistant 9110309 1/10/2023
FODERA, FRANK ANTHONY Prescribing Physician Assistant Physician Assistant 9117300 5/25/2023
FREEMAN, KELLIE CHRISTINE Prescribing Physician Assistant Physician Assistant 9110742 8/1/2024
GLEAVES, RACHEL Prescribing Physician Assistant Physician Assistant 9117325 5/19/2023
GOGLIO, ALEC PERRY Prescribing Physician Assistant Physician Assistant 9117740 9/1/2023
HARDEN, KYLE Prescribing Physician Assistant Physician Assistant 9113509 3/21/2023
HAVERCHAK, ALEXANDRA Prescribing Physician Assistant Physician Assistant 9115748 1/10/2023
HUMMEL, LAURA Prescribing Physician Assistant Medical Doctor 127881 11/1/2023
JOHNSON, HEATHER ANNE Prescribing Physician Assistant Physician Assistant 3023 1/10/2023
KAZAR, JAMIE LYNN Prescribing Physician Assistant Physician Assistant 9117682 9/20/2023
KHURRAM, SEHRISH Prescribing Physician Assistant Physician Assistant 9118360 8/1/2024
KRUGER, MARK SAUL Subordinate Medical Doctor 43984 8/1/2018
LIVOTI, REINALDO Prescribing Physician Assistant Physician Assistant 9118153 10/30/2023
MAFFEO, HEATHER NICOLE Prescribing Physician Assistant Physician Assistant 9117673 7/28/2023
MONROE, BRADLEY SEAN Prescribing Physician Assistant Physician Assistant 9115248 1/10/2023
NICHOLS, ALEXANDER CARL Prescribing Physician Assistant Physician Assistant 9117561 7/12/2023
PABST II, DAVID J Prescribing Physician Assistant Physician Assistant 9117468 5/25/2023
PARKS, THOMAS EDWARD Prescribing Physician Assistant Physician Assistant 9105210 1/10/2023
PASHEGOBA, STEVEN LEE Prescribing Physician Assistant Physician Assistant 9101722 1/10/2023
PELLISSIER, OLIVIA MARIE Prescribing Physician Assistant Physician Assistant 9118062 10/19/2023
REEVES, TRAVIS LANCE Prescribing Physician Assistant Physician Assistant 9110296 1/10/2023
RESTREPO, GLISET Prescribing Physician Assistant Physician Assistant 9110146 1/10/2023
RIZZO, MARISSA Prescribing Physician Assistant Physician Assistant 9114944 3/21/2023
SAMUEL, PETER AIAD Prescribing Physician Assistant Medical Doctor 132116 1/10/2023
SCHLEIF, ROBERT DAVID Prescribing Physician Assistant Physician Assistant 9112559 8/26/2022
SMITH, ALLISTAIR Prescribing Physician Assistant Physician Assistant 9111535 11/22/2022
SORDAN, MICHAEL ROLF Prescribing Physician Assistant Physician Assistant 9115648 1/10/2023
STINEBECK, JARED C Prescribing Physician Assistant Physician Assistant 9105546 1/10/2023
SUCKOW, WENDY SUE Prescribing Physician Assistant Physician Assistant 9101731 1/10/2023
WANZER, ASHLEY Prescribing Physician Assistant Physician Assistant 9112753 7/19/2023
YEH, ANDERSON Prescribing Physician Assistant Physician Assistant 9113431 7/14/2023

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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.