Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bonnie Rose Fox, PA

Individual provider Physician Assistant · NPI 1740590454

Bonnie Rose Fox, PA is a Physician Assistant in Cocoa Beach, Florida. Qualified in 2010, 16 years ago. Practices with Shadetree Dermatology LLC, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
16
Licensed in
FL
In the registry since
2010
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

105 S Banana River Blvd Fl 2
Cocoa Beach, FL 32931-5041
Phone: (321) 200-0346
Fax: (321) 461-6667
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 389 Commerce Pkwy Ste 160, Rockledge, FL 32955-4202 — (321) 200-0346

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA 9105677 (FL)

Record details

NPI number1740590454
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 15, 2010
Last updated in NPPESMarch 27, 2026
Certification dateMarch 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Shadetree Dermatology Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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