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MARY KATHLEEN BISTER

License Number: ME156254

Data As Of 12/22/2024

Profession
Medical Doctor
License
ME156254
License Status
CLEAR/Active
License Expiration Date
1/31/2026
License Original Issue Date
04/15/2022
Address of Record
2716 Country Woods Lane
PALM HARBOR, FL 34683
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date

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

Name Relationship Profession License Effective Date
ABBOTT, SHERYL LYNN Prescribing Physician Assistant Physician Assistant 9116106 2/1/2023
BARQUIN, JOSE MIGUEL JR Prescribing Physician Assistant Medical Doctor 131689 9/1/2024
BEAUCHAMP, STEFANIE Prescribing Physician Assistant Physician Assistant 9115527 9/25/2023
BOLTON, ASHLEY MARIE Prescribing Physician Assistant Physician Assistant 9108069 9/25/2023
BOWMAN, RYAN SCOTT Prescribing Physician Assistant Physician Assistant 9117823 9/12/2023
BREEN, JENA LYNN Prescribing Physician Assistant Physician Assistant 9108857 9/25/2023
CASELLAS, AMBER CHEYENNE Prescribing Physician Assistant Physician Assistant 9109320 9/27/2023
CLINE, JESSICA MARIE LYNN Prescribing Physician Assistant Physician Assistant 9116036 10/20/2023
COLLOM, NEIL EDWARD Prescribing Physician Assistant Physician Assistant 9111249 11/15/2024
CRAMER, GREGORY ROBERT Prescribing Physician Assistant Physician Assistant 9116628 9/25/2023
CRAWFORD, PERRY WILLIAM Prescribing Physician Assistant Physician Assistant 9113494 8/11/2023
CUNNINGHAM, ANDREW Prescribing Physician Assistant Physician Assistant 9112114 9/25/2023
DAVIES, MELANIE JAYNE Prescribing Physician Assistant Physician Assistant 9109114 9/25/2023
DEMARSE, WILLIAM ROBEY III Prescribing Physician Assistant Physician Assistant 9101285 1/10/2023
DIEHL, NATHAN JEROLD Prescribing Physician Assistant Physician Assistant 9113328 9/25/2023
DOLAN, NICHOLAS ALEXANDER Prescribing Physician Assistant Physician Assistant 9113623 9/25/2023
EDGINTON, SIMON ROY M D Prescribing Physician Assistant Medical Doctor 74221 1/10/2023
FELDMAN, TRAVIS SCOTT Prescribing Physician Assistant Physician Assistant 9110309 9/25/2023
FERNANDEZ, FRANKLIN JOSE Prescribing Physician Assistant Physician Assistant 9117044 9/25/2023
FODERA, FRANK ANTHONY Prescribing Physician Assistant Physician Assistant 9117300 9/25/2023
FREEMAN, KELLIE CHRISTINE Prescribing Physician Assistant Physician Assistant 9110742 8/1/2024
GLEAVES, RACHEL Prescribing Physician Assistant Physician Assistant 9117325 5/19/2023
GOGLIO, ALEC PERRY Prescribing Physician Assistant Physician Assistant 9117740 9/1/2023
HAGEWOOD, STEVEN STALLENS Prescribing Physician Assistant Physician Assistant 9110717 9/25/2023
HARDEN, KYLE Prescribing Physician Assistant Physician Assistant 9113509 6/1/2023
HAVERCHAK, ALEXANDRA Prescribing Physician Assistant Physician Assistant 9115748 9/25/2023
HUGNEY, DANIELLE NICOLE Prescribing Physician Assistant Physician Assistant 9117466 9/25/2023
JOHNSON, HEATHER ANNE Prescribing Physician Assistant Physician Assistant 3023 1/10/2023
JONES, LINDSEY GAIL Prescribing Physician Assistant Physician Assistant 9114709 9/25/2023
KAZAR, JAMIE LYNN Prescribing Physician Assistant Physician Assistant 9117682 9/20/2023
KHURRAM, SEHRISH Prescribing Physician Assistant Physician Assistant 9118360 8/1/2024
KIMMERLING, ADAM TYLER Prescribing Physician Assistant Physician Assistant 9108682 9/25/2023
KINSEY, RICHARD RAYMOND JR Prescribing Physician Assistant Physician Assistant 9101145 9/25/2023
KNOTEN, LAUREN Prescribing Physician Assistant Physician Assistant 9110039 9/25/2023
KOKJOHN, KRISTEN LYNN Prescribing Physician Assistant Physician Assistant 9116466 9/25/2023
KUPKE, WILLIAM ROBERT Prescribing Physician Assistant Physician Assistant 9113667 9/25/2023
LANCASTER, CHRISTOPHER ALEXANDER Prescribing Physician Assistant Physician Assistant 9104840 9/25/2023
LARIMORE, TRAVIS LEE Prescribing Physician Assistant Physician Assistant 9106146 9/25/2023
LAVINA, JAY PATRICK Prescribing Physician Assistant Physician Assistant 9102410 9/25/2023
LIVOTI, REINALDO Prescribing Physician Assistant Physician Assistant 9118153 10/30/2023
LUDWIG, RICHARD EUGENE Prescribing Physician Assistant Physician Assistant 9102456 9/25/2023
LYNCH, KATIE Prescribing Physician Assistant Physician Assistant 9110528 9/25/2023
MADDALONI, ANGELINA Prescribing Physician Assistant Physician Assistant 9115757 9/25/2023
MAFFEO, HEATHER NICOLE Prescribing Physician Assistant Physician Assistant 9117673 7/28/2023
MIAH, BAHAR Prescribing Physician Assistant Medical Doctor 108183 2/16/2023
MONROE, BRADLEY SEAN Prescribing Physician Assistant Physician Assistant 9115248 9/25/2023
MUTZ, DANIEL ADAM Prescribing Physician Assistant Physician Assistant 9117071 9/25/2023
NICHOLS, ALEXANDER CARL Prescribing Physician Assistant Physician Assistant 9117561 9/25/2023
NUNEZ-CUBILLAS, ALBERTO Prescribing Physician Assistant Physician Assistant 9101680 9/25/2023
PABST II, DAVID J Prescribing Physician Assistant Physician Assistant 9117468 9/25/2023
PARKS, THOMAS EDWARD Prescribing Physician Assistant Physician Assistant 9105210 1/10/2023
PASHEGOBA, STEVEN LEE Prescribing Physician Assistant Physician Assistant 9101722 1/10/2023
PATEL, KRISTA WEST Prescribing Physician Assistant Physician Assistant 9113096 9/25/2023
PELLISSIER, OLIVIA MARIE Prescribing Physician Assistant Physician Assistant 9118062 10/19/2023
PRUITT, JAMES ALLEN Prescribing Physician Assistant Medical Doctor 142076 1/10/2023
REEVES, TRAVIS LANCE Prescribing Physician Assistant Physician Assistant 9110296 9/25/2023
RESTREPO, GLISET Prescribing Physician Assistant Physician Assistant 9110146 1/10/2023
RINI, JACLYN Prescribing Physician Assistant Physician Assistant 9108634 9/25/2023
RIZZO, MARISSA Prescribing Physician Assistant Physician Assistant 9114944 9/25/2023
ROCKHOLD, AMY MARIE Prescribing Physician Assistant Physician Assistant 9109412 9/25/2023
SAMMY, NYRON MCKENZIE Prescribing Physician Assistant Physician Assistant 9113123 11/15/2024
SCHLEIF, ROBERT DAVID Prescribing Physician Assistant Physician Assistant 9112559 9/25/2023
SIMPSON, ALISON L Prescribing Physician Assistant Medical Doctor 74810 1/10/2023
SKIDMORE, JUSTIN STUART Prescribing Physician Assistant Physician Assistant 9110082 9/25/2023
SMITH, IMELDA Prescribing Physician Assistant Physician Assistant 9115912 9/25/2023
SORDAN, MICHAEL ROLF Prescribing Physician Assistant Physician Assistant 9115648 9/25/2023
STINEBECK, JARED C Prescribing Physician Assistant Physician Assistant 9105546 9/25/2023
SUCKOW, WENDY SUE Prescribing Physician Assistant Physician Assistant 9101731 9/25/2023
SUSSMAN, MICHAEL LORNE Prescribing Physician Assistant Physician Assistant 9107280 9/25/2023
TINGLER, TARA LYNN Prescribing Physician Assistant Physician Assistant 9102755 9/25/2023
TIRHEIMER, WENZEL III Prescribing Physician Assistant Medical Doctor 83294 1/10/2023
WANZER, ASHLEY Prescribing Physician Assistant Physician Assistant 9112753 7/19/2023
WATTERS, JOSEPH Prescribing Physician Assistant Physician Assistant 9112435 9/25/2023
WILSON, NANCY JOANN Prescribing Physician Assistant Physician Assistant 9105925 9/25/2023
YEH, ANDERSON Prescribing Physician Assistant Physician Assistant 9113431 7/14/2023

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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.