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

Individual provider Medical Physician Assistant · NPI 1902170327

Erichsen R Bonostro, PAC is a Physician Assistant in Lakeland, Florida. Qualified in 2008, 18 years ago. Practices with Lakeland Regional Health Systems Inc, a 503-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
18
Licensed in
FL
In the registry since
2012
Specialties on file
2
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

1324 Lakeland Hills Blvd
Lakeland, FL 33805-4543
Phone: (863) 687-1321
Fax: (863) 284-1730
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA9106442 (FL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA9106442 (FL)

Record details

NPI number1902170327
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedMarch 2, 2012
Last updated in NPPESJuly 7, 2017

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Lakeland Regional Health Systems Inc — 503 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Lakeland