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NICHOLAS MADATHILATE

License Number: AA1020

Data As Of 12/23/2024

Profession
Anesthesiologist Assistant
License
AA1020
License Status
CLEAR/Active
License Expiration Date
1/31/2027
License Original Issue Date
10/18/2024
Address of Record
856 Dahoon Cir
VENICE, FL 34293
Discipline on File
No
Public Complaint
No
Address
119 OAKFIELD DR
BRANDON, FL 33511
Name Relationship Profession License Effective Date
ALLEE, JOY Supervising ME Medical Doctor 107342 12/13/2024
ANDRES, JASON B Supervising ME Osteopathic Physician 19568 12/13/2024
ATTAALLAH, AHMED FIKRY Supervising ME Medical Doctor 102788 12/13/2024
BARSOUM, GEORGE Supervising ME Medical Doctor 140156 12/13/2024
BEGGS, KIM Supervising ME Osteopathic Physician 19352 12/13/2024
BENNETT, AMANDA LAUREN Supervising ME Medical Doctor 159199 12/13/2024
BOWSER, RICHARD P Supervising ME Medical Doctor 140969 12/13/2024
CHRISTOPOULOS, JAMES LEON Supervising ME Medical Doctor 73026 12/13/2024
CUPIDO, MATTHEW JOSEPH Supervising ME Osteopathic Physician 13170 12/13/2024
DAVIS, KATHLEEN MARIE Supervising ME Medical Doctor 134389 12/13/2024
DEL VALLE, PAUL GASTON Supervising ME Medical Doctor 159543 12/13/2024
ESCOBAR, ENRIQUE DIEGO Supervising ME Medical Doctor 118044 12/13/2024
FLAVIN, KATHRYN Supervising ME Medical Doctor 136753 12/13/2024
GOMEZ, ORLANDO Supervising ME Osteopathic Physician 16075 12/13/2024
HUSSAIN, INTESAR Supervising ME Medical Doctor 133007 12/13/2024
KELLEDY, PATRICK Supervising ME Medical Doctor 157124 12/13/2024
KIM, CALVIN K MD Supervising ME Medical Doctor 61569 12/13/2024
KRAMER, DANIEL Supervising ME Osteopathic Physician 7393 12/13/2024
LECLAIR, NICOLE JACLYN DO Supervising ME Osteopathic Physician 19761 12/13/2024
LEE, EDWARD JOONHO Supervising ME Medical Doctor 117181 12/13/2024
LI, YUE MONICA Supervising ME Medical Doctor 143912 12/13/2024
LIPSKA, ANNA Supervising ME Medical Doctor 93703 12/13/2024
LOWERY, DAVID ROBERT Supervising ME Medical Doctor 147741 12/13/2024
LUZARDO GRANADOS, GERMAN ENRIQUE Supervising ME Medical Doctor 103190 12/13/2024
MAHESHWARI, NEERAJ Supervising ME Medical Doctor 163132 12/13/2024
MONTANA, GEMA Supervising ME Medical Doctor 151680 12/13/2024
MUNESES, CLIFFORD Supervising ME Medical Doctor 140178 12/13/2024
O'TOOLE, JAMES THOMAS Supervising ME Medical Doctor 135702 12/13/2024
PAGE, PATRICK Supervising ME Medical Doctor 154817 12/13/2024
PALMERI, SHAWN ROBERT Supervising ME Medical Doctor 139346 12/13/2024
PATEL, SAGAR K Supervising ME Osteopathic Physician 16403 12/13/2024
RESNICK, ANDREW SCOT Supervising ME Medical Doctor 159077 12/13/2024
SHAH, MAHIMA Supervising ME Osteopathic Physician 18549 12/13/2024
TAMMINEEDI, SRINIVAS Supervising ME Medical Doctor 98497 12/13/2024
UMHOLTZ, MATTHEW JAMES Supervising ME Osteopathic Physician 12498 12/13/2024
WEBBER, BETH TRUEBLOOD Supervising ME Osteopathic Physician 18402 12/13/2024
WEITZNER, H CORY SCOTT Supervising ME Medical Doctor 95455 12/13/2024
WELLS, JASON Supervising ME Medical Doctor 140329 12/13/2024
ZAYAS-BAZAN, FERNANDO Supervising ME Medical Doctor 121049 12/13/2024

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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 12/23/2024



* 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.