License Verification
NATHAN KEITH WALDREP
License Number: ME58834
Data As Of 11/21/2024
- Address
- 11178 State Road 54 Ste B
- NEW PORT RICHEY, FL 34655
- Address
- 18610 Fernview St
- LAND O LAKES, FL 34638
- Address
- 2442 Bloomingdale Ave
- VALRICO, FL 33596
- Address
- 10125 Big Bend Rd Ste 100
- RIVERVIEW, FL 33578
- Address
- 2645 S Florida Ave Ste 5
- LAKELAND, FL 33803
- Address
- 3351 N McMullen Booth Rd
- CLEARWATER, FL 33761
- Address
- 1599 66th Street N
- SAINT PETERSBURG, FL 33710
- Address
- 1155 S. Dale Mabry Hwy Ste 7
- TAMPA, FL 33629
- Address
- 6455 Gulf Blvd
- ST.PETE BEACH, FL 33706
- Address
- 17512 Dona Michelle Drive Ste 5
- TAMPA PALMS, FL 33647
- Address
- 2331 4th Street North
- SAINT PETERSBURG, FL 33704
- Address
- 3440 W. Dr. MLK Blvd Ste 100
- TAMPA, FL 33607
- Address
- 36245 US Highway 27
- HAINES CITY, FL 33844
- Address
- 711 S Belcher Road
- CLEARWATER, FL 33764
- Address
- 11921 N. Dale Mabry Hwy Suite 7
- TAMPA, FL 33618
- Address
- 4821 US HIGHWAY 19 N STE 5
- NEW PORT RICHEY, FL 34652
- Address
- 400 1ST STREET NORTH BAYCARE URGENT CARE
- WINTER HAVEN, FL 33881
| Name | Relationship | Profession | License | Effective Date |
|---|---|---|---|---|
| WALDREP, NATHAN KEITH | Supervising Prescribing Practitioner | Medical Doctor | 58834 | 01/03/2024 |
Click on the License Number to view License Details for that Practitioner
| Name | Relationship | Profession | License | Effective Date |
|---|---|---|---|---|
| BAKER, PETE ISAAC | Dispensing Physician Assistant | Physician Assistant | 9108060 | 10/4/2016 |
| BAKER, PETE ISAAC | Prescribing Physician Assistant | Physician Assistant | 9108060 | 9/16/2016 |
| BAYFRONT ENTERPRISES INC | HCCE | Health Care Clinic Establishment Permit | 4316 | 2/23/2011 |
| BAYFRONT ENTERPRISES INC | HCCE | Health Care Clinic Establishment Permit | 4317 | 2/23/2011 |
| BAYFRONT ENTERPRISES INC. | HCCE | Health Care Clinic Establishment Permit | 4204 | 2/23/2011 |
| BAYFRONT ENTERPRISES INC. | HCCE | Health Care Clinic Establishment Permit | 4203 | 2/23/2011 |
| BAYFRONT ENTERPRISES INC. | HCCE | Health Care Clinic Establishment Permit | 4315 | 2/23/2011 |
| BAYFRONT ENTERPRISES INC. | HCCE | Health Care Clinic Establishment Permit | 4314 | 2/23/2011 |
| BOWLES, ALICIA | Dispensing Physician Assistant | Physician Assistant | 9118903 | 6/21/2024 |
| BOWLES, ALICIA | Prescribing Physician Assistant | Physician Assistant | 9118903 | 6/21/2024 |
| BOWN, KENT DOUGLAS | Dispensing Physician Assistant | Physician Assistant | 9101655 | 7/6/2017 |
| BURGESS, ALLISON REBECCA PA-C | Dispensing Physician Assistant | Physician Assistant | 9108894 | 11/27/2023 |
| BURGESS, ALLISON REBECCA PA-C | Prescribing Physician Assistant | Physician Assistant | 9108894 | 4/25/2020 |
| BURNS, KATHRYN SHELLY | Dispensing Physician Assistant | Physician Assistant | 9107030 | 7/31/2017 |
| BURNS, KATHRYN SHELLY | Prescribing Physician Assistant | Physician Assistant | 9107030 | 7/31/2017 |
| COBB WEYAND, ALYSSA CLAIRE | Prescribing Physician Assistant | Physician Assistant | 9109483 | 4/14/2020 |
| DASBACH, CHRISTOPHER | Dispensing Physician Assistant | Physician Assistant | 9113019 | 12/17/2022 |
| DASBACH, CHRISTOPHER | Prescribing Physician Assistant | Physician Assistant | 9113019 | 12/17/2022 |
| DEPANICIS, KAYLA | Prescribing Physician Assistant | Physician Assistant | 9112165 | 4/28/2020 |
| DUQUETTE, MCKENNA | Dispensing Physician Assistant | Physician Assistant | 9111736 | 11/18/2020 |
| DUQUETTE, MCKENNA | Prescribing Physician Assistant | Physician Assistant | 9111736 | 12/10/2020 |
| ELMORE, MELANIE DIANA | Prescribing Physician Assistant | Physician Assistant | 9109652 | 11/3/2021 |
| FREEMAN, KELLIE CHRISTINE | Dispensing Physician Assistant | Physician Assistant | 9110742 | 1/3/2024 |
| FREEMAN, KELLIE CHRISTINE | Prescribing Physician Assistant | Physician Assistant | 9110742 | 1/3/2024 |
| GARRY, SHARON LYNN | Dispensing Physician Assistant | Physician Assistant | 9109187 | 4/9/2018 |
| GARRY, SHARON LYNN | Prescribing Physician Assistant | Physician Assistant | 9109187 | 4/9/2018 |
| GONNELLA, DAVID | Dispensing Physician Assistant | Physician Assistant | 9114776 | 11/3/2021 |
| GONNELLA, DAVID | Prescribing Physician Assistant | Physician Assistant | 9114776 | 11/3/2021 |
| HENDERSON, MICHAEL JOHN | Dispensing Physician Assistant | Physician Assistant | 9113306 | 6/1/2022 |
| HENDERSON, MICHAEL JOHN | Prescribing Physician Assistant | Physician Assistant | 9113306 | 6/1/2022 |
| HODGES, CHRISTA RENE | Prescribing Physician Assistant | Physician Assistant | 9106209 | 12/6/2016 |
| HOGAN, ERIN LEIGH | Dispensing Physician Assistant | Physician Assistant | 9105744 | 5/1/2022 |
| HOGAN, ERIN LEIGH | Prescribing Physician Assistant | Physician Assistant | 9105744 | 5/1/2022 |
| KANNER, KIRSTY GREAVES | Dispensing Physician Assistant | Physician Assistant | 9105336 | 3/19/2018 |
| KANNER, KIRSTY GREAVES | Prescribing Physician Assistant | Physician Assistant | 9105336 | 3/19/2018 |
| KINNEY, ANDREW STUART | Dispensing Physician Assistant | Physician Assistant | 9106088 | 1/10/2017 |
| KINNEY, ANDREW STUART | Prescribing Physician Assistant | Physician Assistant | 9106088 | 1/4/2017 |
| KOFFMAN, JESSICA PATRICIA | Dispensing Physician Assistant | Physician Assistant | 9105789 | 11/17/2023 |
| KOFFMAN, JESSICA PATRICIA | Prescribing Physician Assistant | Physician Assistant | 9105789 | 11/17/2023 |
| KOPER, KOREY EDWARD | Prescribing Physician Assistant | Physician Assistant | 9111863 | 4/23/2020 |
| LEPAK-LONG, ERICA LYNSEY | Dispensing Physician Assistant | Physician Assistant | 9110115 | 4/2/2018 |
| LEPAK-LONG, ERICA LYNSEY | Prescribing Physician Assistant | Physician Assistant | 9110115 | 4/2/2018 |
| LY, BAO-KHUYEN NGUYEN | Dispensing Physician Assistant | Physician Assistant | 9112468 | 11/18/2020 |
| LY, KEVIN | Prescribing Physician Assistant | Physician Assistant | 9112466 | 9/13/2021 |
| MACKINNON, CHRISTINE MARIE | Prescribing Physician Assistant | Physician Assistant | 9110833 | 4/23/2020 |
| MASCARIN, JACLYN LORI | Prescribing Physician Assistant | Physician Assistant | 9107043 | 4/21/2020 |
| MCCREIGHT, TRISHA RAE PA-C | Prescribing Physician Assistant | Physician Assistant | 9102440 | 5/13/2020 |
| MCDOUGLE, TANNELLE OLIVIA | Prescribing Physician Assistant | Physician Assistant | 9107285 | 3/15/2023 |
| MEEK, MARY JO | Dispensing Physician Assistant | Physician Assistant | 9109242 | 6/27/2017 |
| MEEK, MARY JO | Prescribing Physician Assistant | Physician Assistant | 9109242 | 6/26/2017 |
| MUTZ, BRIANNA | Dispensing Physician Assistant | Physician Assistant | 9116974 | 12/28/2023 |
| MUTZ, BRIANNA | Prescribing Physician Assistant | Physician Assistant | 9116974 | 12/28/2023 |
| PALMIERI, DANIELLE MARIE | Dispensing Physician Assistant | Physician Assistant | 9103534 | 3/7/2022 |
| PALMIERI, DANIELLE MARIE | Prescribing Physician Assistant | Physician Assistant | 9103534 | 3/7/2022 |
| PHELAN, LEILANI OTERO | Prescribing Physician Assistant | Physician Assistant | 9106375 | 6/11/2020 |
| PHELAN, SEAN THOMAS | Prescribing Physician Assistant | Physician Assistant | 9105896 | 6/17/2020 |
| PROCTOR, SARA KAY | Dispensing Physician Assistant | Physician Assistant | 2530 | 11/3/2021 |
| PROCTOR, SARA KAY | Prescribing Physician Assistant | Physician Assistant | 2530 | 11/3/2021 |
| SALAMEH, NOUR | Dispensing Physician Assistant | Physician Assistant | 9117451 | 2/14/2024 |
| SALAMEH, NOUR | Prescribing Physician Assistant | Physician Assistant | 9117451 | 2/14/2024 |
| SCHIEBEL, AMANDA WETHERBEE | Dispensing Physician Assistant | Physician Assistant | 9105172 | 5/21/2021 |
| SOUTH, JOE | Prescribing Physician Assistant | Physician Assistant | 9111972 | 4/28/2020 |
| TALHOUK, MICHAEL DAVID | Prescribing Physician Assistant | Physician Assistant | 9109253 | 4/29/2020 |
| TIGHT, DOUGLAS F | Dispensing Physician Assistant | Physician Assistant | 3407 | 11/18/2020 |
| TIGHT, DOUGLAS F | Prescribing Physician Assistant | Physician Assistant | 3407 | 4/20/2020 |
| USSIA, NICOLE | Dispensing Physician Assistant | Physician Assistant | 9116817 | 7/3/2023 |
| USSIA, NICOLE | Prescribing Physician Assistant | Physician Assistant | 9116817 | 7/3/2023 |
| WALDREP, NATHAN KEITH | Prescribing Physician Assistant | Medical Doctor | 58834 | 1/3/2024 |
| WARKOMSKI, MEGAN R | Prescribing Physician Assistant | Physician Assistant | 9105452 | 5/19/2020 |
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 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.
