License Verification

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KAILEY KOONTZ

License Number: PA9113974

Data As Of 11/1/2025

Profession
Physician Assistant
License
PA9113974
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
01/15/2021
Address of Record
410 SR-436 E Unit 1020
ALTAMONTE SPRINGS, FL 32701
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1328 N Woodland Blvd
DELAND, FL 32720
Address
4670 Marigold Ave
KISSIMMEE, FL 34758
Address
5845 Winter Garden Vineland Rd
WINDERMERE, FL 34786
Address
92 E Mitchell-Hammock Rd
OVIEDO, FL 32765
Address
13935 Landstar BLVD UNIT 150
ORLANDO, FL 32824
Address
2438 Kirkman Rd
ORLANDO, FL 32811
Address
805 County Road 466
LADY LAKE, FL 32159
Address
628 Cagan View Road
CLERMONT, FL 34714
Address
8972 Turkey Lake Rd S, Suite A- 400
ORLANDO, FL 32819
Address
5102 W SR 46
SANFORD, FL 32771
Address
7460 University Blvd suite 110
WINTER PARK, FL 32792
Address
901 Currency Circle unit 1001
LAKE MARY, FL 32746
Name Relationship Profession License Effective Date
JOHNSON, KEVIN EDMUND Supervising Prescribing Practitioner Medical Doctor 124826 03/26/2025

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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 11/1/2025



* 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.