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KRYSTA-GAYE LATOYA BURCHENSON

License Number: PA9108009

Data As Of 5/20/2024

Profession
Physician Assistant
License
PA9108009
License Status
CLEAR/Active
Qualifications
Prescribing
License Expiration Date
1/31/2026
License Original Issue Date
06/23/2014
Address of Record
1000 Waterman Way
Florida Hospital Waterman
TAVARES, FL 32778
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
1000 WATERMAN WAY FLORIDA HOSPITAL WATERMAN
TAVARES, FL 32778
Name Relationship Profession License Effective Date
BABB, KEVIN OLIVER Supervising Prescribing Practitioner Medical Doctor 130725 03/27/2018
BACASNOT, JEROME Supervising Prescribing Practitioner Medical Doctor 132578 03/27/2018
BASTERRECHEA, HUGO ROMULO Supervising Prescribing Practitioner Medical Doctor 104965 03/27/2018
BAUMGARDNER, MAXEN LANE Supervising Prescribing Practitioner Osteopathic Physician 10872 03/27/2018
BENNETT, MILES CLARK Supervising Prescribing Practitioner Osteopathic Physician 10955 03/27/2018
BIRENBAUM, DALE SCOTT MD Supervising Prescribing Practitioner Medical Doctor 72696 03/27/2018
BLEVINS, GRAIG EDWARD Supervising Prescribing Practitioner Osteopathic Physician 12408 03/27/2018
BOWLS, BRADFORD JORDAN Supervising Prescribing Practitioner Medical Doctor 76194 03/27/2018
BRAHMBHATT, ALKESH PRAVIN Supervising Prescribing Practitioner Osteopathic Physician 8985 03/27/2018
CABATU, AMABEL-JOVAN CHUA MD Supervising Prescribing Practitioner Medical Doctor 96128 03/27/2018
CAMACHO-ACEVEDO, LESLIE ROSIE Supervising Prescribing Practitioner Medical Doctor 125213 03/27/2018
CARON, JESSE ANTHONY Supervising Prescribing Practitioner Medical Doctor 99918 03/27/2018
CHARNAS, JEANNE MARIE SMREKAR Supervising Prescribing Practitioner Medical Doctor 72486 03/27/2018
CHEESEBREW, JOHN FRANKLIN II Supervising Prescribing Practitioner Medical Doctor 119183 03/27/2018
CHESLOCK, TIMOTHY JOHN Supervising Prescribing Practitioner Osteopathic Physician 12099 03/27/2018
CHIN, KEVIN WESLEY Supervising Prescribing Practitioner Medical Doctor 130328 03/27/2018
CISNEROS, LEONARDO Supervising Prescribing Practitioner Osteopathic Physician 8015 03/27/2018
CLAYTON, JEROME Supervising Prescribing Practitioner Medical Doctor 127193 03/27/2018
CLEVELAND, RENEE MICHELLE Supervising Prescribing Practitioner Medical Doctor 79367 03/27/2018
COOPER, HERBERT PRESS III Supervising Prescribing Practitioner Medical Doctor 91330 03/27/2018
CORTES-BELEN, ERNESTO MD Supervising Prescribing Practitioner Medical Doctor 76249 03/27/2018
CUBERO, ISMAEL CANDIDO Supervising Prescribing Practitioner Medical Doctor 126889 03/27/2018
DALEY, JANIN CHRISTIN Supervising Prescribing Practitioner Medical Doctor 123412 03/27/2018
DENNEY, CLIFFORD JOSEPH MD Supervising Prescribing Practitioner Medical Doctor 106797 03/27/2018
DIAZ BALZAC, ROBERTO J Supervising Prescribing Practitioner Medical Doctor 127423 03/27/2018
DOTSON, TRACE M Supervising Prescribing Practitioner Osteopathic Physician 12691 03/27/2018
FERNANDEZ FERNANDEZ, JUAN RAFAEL Supervising Prescribing Practitioner Medical Doctor 127278 03/27/2018
FRIEND, VICKI KAY DO Supervising Prescribing Practitioner Osteopathic Physician 7562 03/27/2018
FRISCH, MARK SCOTT Supervising Prescribing Practitioner Medical Doctor 96093 03/27/2018
GALLEGOS, LAURA ELISA ALDARONDO Supervising Prescribing Practitioner Medical Doctor 107281 03/27/2018
GOLDMAN, DAVID DO Supervising Prescribing Practitioner Osteopathic Physician 8129 03/27/2018
GRAZIANO, JENNY D Supervising Prescribing Practitioner Medical Doctor 99574 03/27/2018
GREGORY, CHRISTEN NICHOLE MD Supervising Prescribing Practitioner Medical Doctor 118702 03/27/2018
GUZMAN MARTINEZ, SAMUEL Supervising Prescribing Practitioner Medical Doctor 89143 03/27/2018
HAUS, DOUGLAS MARTIN Supervising Prescribing Practitioner Osteopathic Physician 12432 03/27/2018
HERNANDEZ, DENNIS ARNALDO Supervising Prescribing Practitioner Medical Doctor 55104 03/27/2018
HORNER, KIMBERLY BOGARD Supervising Prescribing Practitioner Medical Doctor 129828 03/27/2018
JANWADKAR, SHAKUNTALA SANDEEP MD Supervising Prescribing Practitioner Medical Doctor 86339 03/27/2018
KOSCINSKI, FELICE ILENE Supervising Prescribing Practitioner Medical Doctor 70986 03/27/2018
KRUGER, MARK SAUL Supervising Prescribing Practitioner Medical Doctor 43984 03/27/2018
LANKER, MARK DARRYL Supervising Prescribing Practitioner Medical Doctor 111494 03/27/2018
LAPP, JOHN KOEHLER Supervising Prescribing Practitioner Osteopathic Physician 4816 03/27/2018
MANSFIELD, OMAYRA LIZZIE Supervising Prescribing Practitioner Medical Doctor 111757 03/27/2018
MAULDIN, JUSTIN ANTHONY Supervising Prescribing Practitioner Medical Doctor 131802 03/27/2018
MAULFAIR, MITCHELL DEAN Supervising Prescribing Practitioner Osteopathic Physician 7054 03/27/2018
MCLAIN, JOHN IV Supervising Prescribing Practitioner Medical Doctor 118207 03/27/2018
MILLARD, CHRISTOPHER J DO Supervising Prescribing Practitioner Osteopathic Physician 6911 03/27/2018
MIRANDA GONZALEZ, EDGAR JAVIER Supervising Prescribing Practitioner Medical Doctor 132070 03/27/2018
MOLINS, CAROLINE MARIE Supervising Prescribing Practitioner Medical Doctor 107349 03/27/2018
MORA MONTERO, CLARA JULIANA Supervising Prescribing Practitioner Medical Doctor 122709 03/27/2018
NAZARIO, STEVEN Supervising Prescribing Practitioner Medical Doctor 87429 03/27/2018
NEVALA, WAYNE MICHAEL M D Supervising Prescribing Practitioner Medical Doctor 83654 03/27/2018
NICHOLS, PATRICIA Supervising Prescribing Practitioner Medical Doctor 89338 03/27/2018
NOBIE, BRIAN A Supervising Prescribing Practitioner Medical Doctor 87679 03/27/2018
OAKLEY, ANGELA GARCIA M D Supervising Prescribing Practitioner Medical Doctor 56710 03/27/2018
O'BRIEN, PAUL BLAKE MD Supervising Prescribing Practitioner Medical Doctor 95514 03/27/2018
O'GRADY, LISA M Supervising Prescribing Practitioner Medical Doctor 69380 03/27/2018
PAGE, ERNEST II Supervising Prescribing Practitioner Medical Doctor 78546 03/27/2018
POOLE, RICHARD M DO Supervising Prescribing Practitioner Osteopathic Physician 13735 03/27/2018
PUTIGNA, FLORIANO Supervising Prescribing Practitioner Osteopathic Physician 8905 03/27/2018
REYES SANTOS, ALEX FRANCISCO Supervising Prescribing Practitioner Medical Doctor 132290 03/27/2018
RODRIGUEZ, EDGARDO MD Supervising Prescribing Practitioner Medical Doctor 65647 03/27/2018
RODRIGUEZ, MARITZA RODRIGUEZ Supervising Prescribing Practitioner Medical Doctor 69301 03/27/2018
SANDERS, BRETT DOUGLAS Supervising Prescribing Practitioner Medical Doctor 115172 03/27/2018
SANTAMBROSIO, MARC Supervising Prescribing Practitioner Osteopathic Physician 8725 03/27/2018
SARKARATI, DAVID Supervising Prescribing Practitioner Osteopathic Physician 9010 03/27/2018
SIMMONDS, YARELIES MALAVE Supervising Prescribing Practitioner Medical Doctor 126238 03/27/2018
SING, WEYLIN Supervising Prescribing Practitioner Osteopathic Physician 8721 03/27/2018
SMOLTER, PATRICIA ELIZABETH Supervising Prescribing Practitioner Osteopathic Physician 12707 03/27/2018
TEMPEL, RICHARD ANDREW MD Supervising Prescribing Practitioner Medical Doctor 102329 03/27/2018
THABET, ASHRAF Supervising Prescribing Practitioner Osteopathic Physician 11277 03/27/2018
THOMETZ, DONALD PAUL Supervising Prescribing Practitioner Medical Doctor 130218 03/27/2018
TOMECSEK, KEVIN JOSEPH Supervising Prescribing Practitioner Medical Doctor 123302 03/27/2018
VANDERVELDE, KRISTEN C Supervising Prescribing Practitioner Osteopathic Physician 12002 03/27/2018
YORKE, JENNIFER A Supervising Prescribing Practitioner Osteopathic Physician 13134 03/27/2018
YOUNG, VICTOR CHANCE Supervising Prescribing Practitioner Osteopathic Physician 8339 03/27/2018

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No Continuing Education Hours Received from Approved Providers As Of 5/20/2024



* 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.