License Verification

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DIEGO ENRIQUE CARMONA

License Number: PA9106216

Data As Of 5/3/2024

Profession
Physician Assistant
License
PA9106216
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
10/17/2011
Address of Record
350 7th Street North
NAPLES, FL 34102
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
11190 HealthPark Blvd Naples Community Hospital-North Campus
NAPLES, FL 34110
Address
40 S. Healthwood Drive Marco Healthcare Center
MARCO ISLAND, FL 34145
Address
15420 COLLIER BLVD NAPLES COMMUNITY HOSPITAL
NAPLES, FL 34120
Address
40 S. Healthwood Drive Marco Healthcare Center
MARCO ISLAND, FL 34145
Address
11190 Health Park Blvd NCH North Naples
NAPLES, FL 34110
Address
15420 Collier Blvd NCH Healthcare Northeast
NAPLES, FL 34120
Address
24040 S Tamiami Trail
BONITA SPRINGS, FL 34134
Name Relationship Profession License Effective Date
BISHOP, TRACY MARIE Supervising Prescribing Practitioner Osteopathic Physician 16617 10/01/2023
CHAMBERS, JESSICA Supervising Prescribing Practitioner Osteopathic Physician 15853 12/10/2019
CONKLU, EMRE MEHMET Supervising Prescribing Practitioner Osteopathic Physician 10121 10/01/2023
CRUM, MICHAEL Supervising Prescribing Practitioner Medical Doctor 140288 12/10/2019
ESPOSITO, TRAVIS Supervising Prescribing Practitioner Osteopathic Physician 19784 10/01/2023
FARBER, DAVID L Supervising Prescribing Practitioner Medical Doctor 145156 03/11/2021
FRIEDMAN, JOEL Supervising Prescribing Practitioner Medical Doctor 38711 10/01/2023
FRIER, JACOB TROY Supervising Prescribing Practitioner Medical Doctor 141415 12/10/2019
GUFFREY, KATHRYN MARY Supervising Prescribing Practitioner Medical Doctor 137235 12/10/2019
HUMPHRIES, ASHLEY ROSE Supervising Prescribing Practitioner Medical Doctor 160796 10/01/2023
KLEIN, JUSTIN BLAKE Supervising Prescribing Practitioner Osteopathic Physician 13685 10/01/2023
KOULIEV, TIMUR Supervising Prescribing Practitioner Medical Doctor 112603 12/10/2019
KRABACHER, KENNETH DANIEL MD Supervising Prescribing Practitioner Medical Doctor 129897 12/10/2019
KUMETZ, CHRISTOPHER ALEXEI Supervising Prescribing Practitioner Medical Doctor 135191 12/10/2019
LE, TRUNG Supervising Prescribing Practitioner Medical Doctor 154049 10/01/2023
LEE, JULIA SUN MD Supervising Prescribing Practitioner Medical Doctor 111060 12/10/2019
LEWIS, JOHN PATRICK Supervising Prescribing Practitioner Medical Doctor 65873 10/01/2023
LYNCH, TAYLOR Supervising Prescribing Practitioner Medical Doctor 160593 10/01/2023
MACIAN, DIANA MARIA Supervising Prescribing Practitioner Medical Doctor 127444 12/10/2019
MAINOR, BYRON HARRISON Supervising Prescribing Practitioner Medical Doctor 121350 03/08/2021
MALKANI, VIKRAM JAIKRISHEN Supervising Prescribing Practitioner Medical Doctor 146156 11/30/2021
MARITATO, CHRISTOPHER JOHN Supervising Prescribing Practitioner Osteopathic Physician 8219 12/10/2019
MATTA, ELIAS NASSIR Supervising Prescribing Practitioner Medical Doctor 122561 11/30/2021
MIAN, USMAN TARIQ Supervising Prescribing Practitioner Medical Doctor 128350 12/10/2019
PAGE, ERNEST II Supervising Prescribing Practitioner Medical Doctor 78546 09/08/2023
VIOLARIS, JOSEPH Supervising Prescribing Practitioner Medical Doctor 140807 12/10/2019
WIEGERS, EDWARD III Supervising Prescribing Practitioner Osteopathic Physician 14844 12/10/2019
WIETECHA, KATHERINE MARGARET Supervising Prescribing Practitioner Medical Doctor 158560 10/01/2023

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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 5/3/2024



* 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.