License Verification

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WILLIAM CARL MACKENZIE

License Number: PA9112545

Data As Of 12/2/2024

Profession
Physician Assistant
License
PA9112545
License Status
CLEAR/Active
Qualifications
Prescribing
Dispensing Practitioner
License Expiration Date
1/31/2026
License Original Issue Date
09/18/2019
Address of Record
720 W Oak St Suite 303
Kissimmee
KISSIMMEE, FL 34741
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
100 Eslinger Way
SANFORD, FL 32773
Name Relationship Profession License Effective Date
ALLWOOD, KENNETH ALEXANDER MD Supervising Prescribing Practitioner Medical Doctor 76673 10/01/2019
BISHOP, DAVID Supervising Prescribing Practitioner Osteopathic Physician 14926 10/08/2019
BRAHMBHATT, ALKESH PRAVIN Supervising Prescribing Practitioner Osteopathic Physician 8985 10/08/2019
BUFFKIN, KIMBERLY REBECCA Supervising Prescribing Practitioner Medical Doctor 98372 10/08/2019
BUTEL, SHALOM Supervising Prescribing Practitioner Osteopathic Physician 16168 10/08/2019
CHAN, KAHANG LEE Supervising Prescribing Practitioner Medical Doctor 72760 10/08/2019
CHOI, SHEUNG-FU SEAN Supervising Prescribing Practitioner Osteopathic Physician 8419 10/08/2019
CHON, YEONG SUN MD Supervising Prescribing Practitioner Medical Doctor 58075 10/08/2019
CISNEROS, LEONARDO Supervising Prescribing Practitioner Osteopathic Physician 8015 10/08/2019
CLEVELAND, RENEE MICHELLE Supervising Prescribing Practitioner Medical Doctor 79367 10/08/2019
COOPER, HERBERT PRESS III Supervising Prescribing Practitioner Medical Doctor 91330 10/08/2019
CORTES-BELEN, ERNESTO MD Supervising Prescribing Practitioner Medical Doctor 76249 10/08/2019
FRISCH, MARK SCOTT Supervising Prescribing Practitioner Medical Doctor 96093 10/01/2019
GERVAIS, JULIETTE SELMA Supervising Prescribing Practitioner Medical Doctor 99019 10/07/2019
GOLDMAN, DAVID DO Supervising Prescribing Practitioner Osteopathic Physician 8129 10/07/2019
GUZMAN MARTINEZ, SAMUEL Supervising Prescribing Practitioner Medical Doctor 89143 10/07/2019
HAGAN, MARY J Supervising Prescribing Practitioner Osteopathic Physician 13345 10/07/2019
HERNANDEZ, DENNIS ARNALDO Supervising Prescribing Practitioner Medical Doctor 55104 10/07/2019
HILL, DUSTIN NICOLAS Supervising Prescribing Practitioner Medical Doctor 137031 10/07/2019
ISA, IBRAHIM Supervising Prescribing Practitioner Medical Doctor 131853 10/07/2019
JANWADKAR, SHAKUNTALA SANDEEP MD Supervising Prescribing Practitioner Medical Doctor 86339 10/07/2019
JEAN-BAPTISTE, NAOMI Supervising Prescribing Practitioner Medical Doctor 137930 10/08/2019
KING, PAUL WARREN Supervising Prescribing Practitioner Medical Doctor 32814 10/08/2019
KOSCINSKI, FELICE ILENE Supervising Prescribing Practitioner Medical Doctor 70986 10/09/2019
KRUGER, MARK SAUL Supervising Prescribing Practitioner Medical Doctor 43984 10/09/2019
LAPP, JOHN KOEHLER Supervising Prescribing Practitioner Osteopathic Physician 4816 10/09/2019
LOPEZ-FERRER, JORGE JUAN Supervising Prescribing Practitioner Medical Doctor 62776 10/09/2019
LUGO, KATIA MARIE Supervising Prescribing Practitioner Medical Doctor 97451 10/09/2019
MAILLOUX, NICOLE Supervising Prescribing Practitioner Medical Doctor 134503 10/09/2019
MAMMAS, ADAMANTIA ANNA M D Supervising Prescribing Practitioner Medical Doctor 55533 10/09/2019
MANIS, TYLER CORY Supervising Prescribing Practitioner Medical Doctor 136450 10/09/2019
MAULDIN, JUSTIN ANTHONY Supervising Prescribing Practitioner Medical Doctor 131802 10/09/2019
MAULFAIR, MITCHELL DEAN Supervising Prescribing Practitioner Osteopathic Physician 7054 10/09/2019
MOORE, ROSS AARON Supervising Prescribing Practitioner Medical Doctor 136093 10/09/2019
NAZARIO, STEVEN Supervising Prescribing Practitioner Medical Doctor 87429 10/09/2019
NICHOLS, PATRICIA Supervising Prescribing Practitioner Medical Doctor 89338 10/09/2019
NOBIE, BRIAN A Supervising Prescribing Practitioner Medical Doctor 87679 10/09/2019
NUNEZ, RAMON HUNGRIA Supervising Prescribing Practitioner Medical Doctor 95027 10/09/2019
OAKLEY, ANGELA GARCIA M D Supervising Prescribing Practitioner Medical Doctor 56710 10/09/2019
O'BRIEN, PAUL BLAKE MD Supervising Prescribing Practitioner Medical Doctor 95514 10/09/2019
O'GRADY, LISA M Supervising Prescribing Practitioner Medical Doctor 69380 10/09/2019
PAGE, ERNEST II Supervising Prescribing Practitioner Medical Doctor 78546 10/09/2019
PANDYA, KETAN Supervising Prescribing Practitioner Medical Doctor 85671 10/09/2019
PELUSO, VANESSA CHRISTINE Supervising Prescribing Practitioner Medical Doctor 89189 10/09/2019
PEREZ, KIRSA FRIDAL Supervising Prescribing Practitioner Medical Doctor 91119 10/09/2019
POOLE, RICHARD M DO Supervising Prescribing Practitioner Osteopathic Physician 13735 10/09/2019
POOLE, WILLIAM RANDALL Supervising Prescribing Practitioner Medical Doctor 51112 10/09/2019
PUTIGNA, FLORIANO Supervising Prescribing Practitioner Osteopathic Physician 8905 10/09/2019
REYES SANTOS, ALEX FRANCISCO Supervising Prescribing Practitioner Medical Doctor 132290 10/09/2019
RODRIGUEZ, EDGARDO MD Supervising Prescribing Practitioner Medical Doctor 65647 10/09/2019
RODRIGUEZ, MARITZA RODRIGUEZ Supervising Prescribing Practitioner Medical Doctor 69301 10/09/2019
SANTAMBROSIO, MARC Supervising Prescribing Practitioner Osteopathic Physician 8725 10/09/2019
SARKARATI, DAVID Supervising Prescribing Practitioner Osteopathic Physician 9010 10/09/2019
SCHWARTZ, REGAN ANDRE MD Supervising Prescribing Practitioner Medical Doctor 69639 10/09/2019
SHEA, JILL MARIE Supervising Prescribing Practitioner Medical Doctor 136840 10/09/2019
SIMMONS, TAYLOR Supervising Prescribing Practitioner Medical Doctor 131844 10/09/2019
SING, WEYLIN Supervising Prescribing Practitioner Osteopathic Physician 8721 10/01/2019
SIVANESAN, SIVAPRAGASAM Supervising Prescribing Practitioner Medical Doctor 62866 10/09/2019
WARTELLA, JOHN DOUGLAS MD Supervising Prescribing Practitioner Medical Doctor 99649 10/08/2019
WEST, HAROLD KENNETH JR Supervising Prescribing Practitioner Medical Doctor 36939 10/08/2019
ZAYAS MALDONADO, DAY ONILL Supervising Prescribing Practitioner Medical Doctor 131573 10/08/2019
ZITO, TRACY ROSE MD Supervising Prescribing Practitioner Medical Doctor 117294 10/21/2022

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



* 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.