License Verification

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MATHEW DALE TAYLOR

License Number: PA9104772

Data As Of 12/22/2024

Profession
Physician Assistant
License
PA9104772
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
09/10/2008
Address of Record
2000 Fowler Grove Blvd
WINTER GARDEN, FL 34787
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1000 Waterman Way
TAVARES, FL 32778
Address
200 N Lakemont Ave
WINTER PARK, FL 32792
Address
2000 Fowler Avenue
WINTER GARDEN, FL 34787
Address
12194 Lake Underhill Rd
ORLANDO, FL 32825
Address
2500 E Irlo Bronson Memoril
KISSIMMEE, FL 34744
Address
7823 Palm Parkway
ORLANDO, FL 32836
Address
8300 Red bug Lake Rd
OVIEDO, FL 32765
Address
8300 Red Bug Lake Rd
ORLANDO, FL 32827
Address
10080 Lake Nona Blvd
ORLANDO, FL 32827
Address
950 Rinehart Rd
LAKE MARY, FL 32746
Address
601 E Rollins Street
ORLANDO, FL 32803
Address
2450 N Orange Blossom Tr
KISSIMMEE, FL 34744
Address
601 E Rollins Street
ORLANDO, FL 32803
Address
7727 Lake Underhill Rd
ORLANDO, FL 32822
Address
400 Celebration Pl
CELEBRATION, FL 34747
Address
2100 Ocoee
APOPKA, FL 32703
Address
601 E Altamonte DR
ALTAMONTE SPRINGS, FL 32701
Address
200 N Lakemont Ave
WINTER PARK, FL 32792
Address
600 E Dixie Ave
LEESBURG, FL 34748
Address
2000 Fowler Grove
WINTER GARDEN, FL 34787
Address
1909 E Highway 50
CLERMONT, FL 34711
Address
1301 S. International Parkway Suite 2021
LAKE MARY, FL 32746
Name Relationship Profession License Effective Date
ADEWALE, ADEMOLA Supervising Prescribing Practitioner Medical Doctor 87916 07/09/2022
CLEVELAND, RENEE MICHELLE Supervising Prescribing Practitioner Medical Doctor 79367 07/02/2022
DESVARISTES, ROSELINE A Supervising Prescribing Practitioner Medical Doctor 144184 07/23/2022
LEVI, JOSEPH IRA Supervising Prescribing Practitioner Osteopathic Physician 17631 07/19/2022
MOHAR, CAMILO MIGUEL Supervising Prescribing Practitioner Osteopathic Physician 15888 07/01/2022
MONROE, JENNIFER ELIZABETH Supervising Prescribing Practitioner Osteopathic Physician 12672 06/23/2022
NWIZU, MARCEL Supervising Prescribing Practitioner Osteopathic Physician 17671 04/28/2022
RODRIGUEZ, MARITZA RODRIGUEZ Supervising Prescribing Practitioner Medical Doctor 69301 06/23/2022
SCHWARTZ, REGAN ANDRE MD Supervising Prescribing Practitioner Medical Doctor 69639 11/30/2021

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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



* 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.