License Verification

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JONATHAN DAVID XAVIER

License Number: PA9107872

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9107872
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
04/09/2014
Address of Record
6901 Simmons Loop
St Joseph's Hospital - South
RIVERVIEW, FL 33578
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
4211 Van Dyke Rd
LUTZ, FL 33558
Address
3001 W. MLK Jr. Blvd
TAMPA, FL 33607
Address
6901 Simmons Loop St Joseph's Hospital South
RIVERVIEW, FL 33578
Address
4211 VanDyke Road St Joseph's Hospital North
LUTZ, FL 33558
Address
3001 West MLKJr. Blvd St Joseph's Hospital-Tampa
TAMPA, FL 33607
Name Relationship Profession License Effective Date
CHRISTIANO, DANIELLE MARIE Supervising Prescribing Practitioner Medical Doctor 98327 03/16/2016
DEGROAT, JONATHAN THOMAS Supervising Prescribing Practitioner Medical Doctor 114356 03/16/2016
DESAI, AJAY Supervising Prescribing Practitioner Osteopathic Physician 12568 03/16/2016
KOONKITTI, PARICHART CANDY Supervising Prescribing Practitioner Medical Doctor 125284 03/16/2016
NESSELROADE, RYAN DAVID Supervising Prescribing Practitioner Medical Doctor 106189 03/16/2016
OSBORNE, AARON RYAN Supervising Prescribing Practitioner Medical Doctor 108215 03/16/2016

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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 12/22/2024



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** 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.


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