License Verification

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JAMIE JESSE JOHNSON

License Number: PA9111384

Data As Of 6/30/2024

Profession
Physician Assistant
License
PA9111384
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
07/12/2018
Address of Record
951 N Washington Ave
TITUSVILLE, FL 32796
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No
Address
6300 N Wickham Road Suite 101 Premier Urgent Care
MELBOURNE, FL 32940
Address
3120 Howland Blvd AdventHealth-Deltona
DELTONA, FL 32725
Address
1055 Saxon Blvd Advent Health Fish Memorial
ORANGE CITY, FL 32763
Address
701 W Plymouth Avenue Advent Health Deland
DELAND, FL 32720
Address
58112 Williamson Blvd AdventHealth Port Orange
PORT ORANGE, FL 32128
Address
60 Memorial Medical Parkway Advent Health Palm Coast
PALM COAST, FL 32164
Address
401 Palmetto Street Advent Health New Smyrna
NEW SMYRNA BEACH, FL 32168
Name Relationship Profession License Effective Date
BARRY, WAYNE S MD Supervising Prescribing Practitioner Medical Doctor 51146 09/21/2018
CANALIZO, JOHN BUCKLEY Supervising Prescribing Practitioner Medical Doctor 67318 09/21/2018
CANTU, MONICA EDITH Supervising Prescribing Practitioner Medical Doctor 122370 09/21/2018
HUGHES, KATHLEEN M MD Supervising Prescribing Practitioner Medical Doctor 45813 09/21/2018
PODHAJSKY, LINDSAY MARIE MD Supervising Prescribing Practitioner Medical Doctor 117041 09/21/2018
RIGA, PETER J Supervising Prescribing Practitioner Osteopathic Physician 10944 12/06/2022

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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 6/30/2024



* 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.