License Verification

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DANIELLE MARIA KINSEY

License Number: PA9103937

Data As Of 7/4/2024

Profession
Physician Assistant
License
PA9103937
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
09/29/2006
Address of Record
10461 10461 Quality Dr
SPRING HILL, FL 34609
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
Yes - Click on Discipline/Admin Action tab to see more details
Public Complaint
Yes - Click on Discipline/Admin Action tab to see more details
Address
11375 Cortez Blvd
BROOKSVILLE, FL 34613
Address
17240 Cortez Blvd
BROOKSVILLE, FL 34601
Address
6201 N. Suncoast Blvd
CRYSTAL RIVER, FL 34428
Address
11375 Cortez Blvd
BROOKSVILLE, FL 34613
Address
10461 Quality Drive
SPRING HILL, FL 34609
Name Relationship Profession License Effective Date
DEAN, DAVID BAHMAN Supervising Dispensing Practitioner Medical Doctor 78794 05/18/2017
DEAN, DAVID BAHMAN Supervising Prescribing Practitioner Medical Doctor 78794 05/18/2017
MIKUS, RAYMOND BERNARD Supervising Prescribing Practitioner Osteopathic Physician 10840 08/17/2017

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date
ALI, MOHAMED SYAD Prescribing Physician Assistant Physician Assistant 9104732 10/25/2023
BASTIN, JOHN PATRICK PA-C Prescribing Physician Assistant Physician Assistant 9110037 10/25/2023
BERRY, RANAE SHANNON Prescribing Physician Assistant Physician Assistant 9103545 10/25/2023
BURNS, AMANDA MICHELLE Prescribing Physician Assistant Physician Assistant 9116653 10/25/2023
CASANOVA, JUDITH Prescribing Physician Assistant Physician Assistant 9105079 10/25/2023
GLARDON, CHRISTIAN GEORGES Prescribing Physician Assistant Physician Assistant 9105689 10/25/2023
HANDT, TYLER JASON Prescribing Physician Assistant Physician Assistant 9116177 10/25/2023
JOHNSON, MICHAEL Prescribing Physician Assistant Physician Assistant 9111371 10/25/2023
LANGDON, PHILLIP NEIL Prescribing Physician Assistant Physician Assistant 9109345 10/25/2023
LEONIDES, ROCIO Prescribing Physician Assistant Physician Assistant 9111441 10/25/2023
MORRIS, SCOTT KIMBERLY Prescribing Physician Assistant Physician Assistant 2885 10/25/2023
NAYEEM, NAZMUL HASAN Prescribing Physician Assistant Physician Assistant 9117106 10/25/2023
PITTMAN, ANNA ELIZABETH CORY Prescribing Physician Assistant Physician Assistant 9108780 10/25/2023
PITTMAN, CARLOS TERRELL Prescribing Physician Assistant Physician Assistant 9107816 10/25/2023
SALAS, JENNIFER LYNNE Prescribing Physician Assistant Physician Assistant 9104807 10/25/2023
SIDUN, NICHOLAS Prescribing Physician Assistant Physician Assistant 9116132 10/25/2023
SMIT, MARIA VALENTI Prescribing Physician Assistant Physician Assistant 9105510 10/25/2023
SMITHBACK, PAIGE CLAIRE Prescribing Physician Assistant Physician Assistant 9117557 10/25/2023
WALKER, DANIELLE LINDSEY Prescribing Physician Assistant Physician Assistant 9103745 10/25/2023
WILEY, AMY HELEN Prescribing Physician Assistant Physician Assistant 9111747 10/25/2023
WILSON, SHERENE NASHARA Prescribing Physician Assistant Physician Assistant 9106036 10/25/2023

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 7/4/2024



* 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.