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

Mr. Brian Keith Bonomo, PAC

Individual provider Physician Assistant · NPI 1124012596

Mr. Brian Keith Bonomo, PAC is a Physician Assistant in Lecanto, Florida. Qualified in 2000, 26 years ago. Practices with Suncoast Skin Solutions, a 99-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
26
Licensed in
FL
In the registry since
2005
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

525 N Dacie Pt
Lecanto, FL 34461-8399
Phone: (352) 746-2200
Fax: (352) 746-9320
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9101264 (FL)

Record details

NPI number1124012596
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedAugust 31, 2005
Last updated in NPPESNovember 12, 2022
Certification dateNovember 12, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Suncoast Skin Solutions — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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