License Verification

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JAIMIN BALWANT PATEL M.D

License Number: ME104797

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME104797
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
06/11/2009
Address of Record
1000 MAR WALT DRIVE
FORT WALTON BEACH, FL 32547
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
Yes
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
MATTEUZZI, KATIE LOU Supervising Prescribing Practitioner Osteopathic Physician 19359 02/13/2024
WEST, KERRI ELESE Supervising Prescribing Practitioner Osteopathic Physician 18404 10/20/2021

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Name Relationship Profession License Effective Date
AMBROSE, JESSICA Prescribing Physician Assistant Physician Assistant 9110160 2/21/2017
ATHEARN, CHERYL PARKER Prescribing Physician Assistant Physician Assistant 9107831 2/15/2019
BERRY, RANAE SHANNON Prescribing Physician Assistant Physician Assistant 9103545 2/7/2020
BUCK, JENNIFER FRANCES Prescribing Physician Assistant Physician Assistant 9106346 2/7/2020
BULLMAN, JONATHAN FAIN Prescribing Physician Assistant Physician Assistant 9107709 9/22/2023
CERANOWSKI, MICHAEL JAMES Prescribing Physician Assistant Physician Assistant 9104159 6/29/2017
CRAWFORD, JIMMIE CONRAD Prescribing Physician Assistant Physician Assistant 9104289 10/28/2016
KEETON, PATRICK RAY Prescribing Physician Assistant Physician Assistant 9107121 2/7/2019
ROMAN, JULIE Prescribing Physician Assistant Physician Assistant 9111426 9/22/2023
SAMSON, JESSICA AURELIO Prescribing Physician Assistant Physician Assistant 9103076 9/22/2023
SIMMONS, LEONARD WILLIAM Prescribing Physician Assistant Physician Assistant 9103209 11/28/2016
WILEY, AMY HELEN Prescribing Physician Assistant Physician Assistant 9111747 9/22/2023
WILKERSON, BENNY RAY JR Prescribing Physician Assistant Physician Assistant 9102065 10/28/2016
WINDFELDER, CHARLES BERNARD Prescribing Physician Assistant Physician Assistant 9103273 10/28/2016

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/22/2024



* 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.