License Verification

Printer Friendly Version

KEITH L LEBRUN

License Number: PA2103

Data As Of 10/19/2026

Profession
Physician Assistant
License
PA2103
License Status
Clear/Active
Qualifications
Prescribing
License Expiration Date
1/31/2028
License Original Issue Date
08/10/1989
Address of Record
1700 S. TAMIAMI TRAIL
SARASOTA EMERGENCY ASSO
SARASOTA, FL 34239
Controlled Substance Prescriber (for the Treatment of Chronic Non-malignant Pain)
No
Discipline on File
No
Public Complaint
No
Address
6813 S. Tamiami Trail
SARASOTA, FL 34231
Address
399 INTERSTATE BLVD. CENTER FOR MEN'S HEALTH
SARASOTA, FL 34240
Name Relationship Profession License Effective Date
ARISTIMUNO, JOAQUIN J Supervising Prescribing Practitioner Medical Doctor 66311 10/19/2026
ARRIETA, JULIO MIGUEL Supervising Prescribing Practitioner Medical Doctor 122510 10/19/2026
BAYINDIRYAN, TEODORA CAROLYN Supervising Prescribing Practitioner Medical Doctor 125443 10/19/2026
BERRY, BRYAN PAUL Supervising Prescribing Practitioner Medical Doctor 120421 10/19/2026
BERRY, TAMMY MARIE Supervising Prescribing Practitioner Medical Doctor 121237 10/19/2026
BRICENO MENDEZ, JOSE VICENTE Supervising Prescribing Practitioner Medical Doctor 106477 10/19/2026
BUTLER, TARA S MD Supervising Prescribing Practitioner Medical Doctor 105696 10/19/2026
CASEBOLT, KEVIN MATTHEW Supervising Prescribing Practitioner Medical Doctor 107113 10/19/2026
CHOY, JOHN YEUK-HIM MD Supervising Prescribing Practitioner Medical Doctor 66467 10/19/2026
DE LA PUENTE, RAFAEL JOSE Supervising Prescribing Practitioner Medical Doctor 118719 10/19/2026
DEAK, ANGELINA Supervising Prescribing Practitioner Osteopathic Physician 11232 10/19/2026
DERESPINO, JAMES A MD Supervising Prescribing Practitioner Medical Doctor 39549 10/19/2026
DOWNES, WILLIAM ANDREW Supervising Prescribing Practitioner Medical Doctor 98640 10/19/2026
GERBER, JOEL LAWRENCE Supervising Prescribing Practitioner Medical Doctor 84098 10/19/2026
GONCALVES, ROSE VALENTINE A Supervising Prescribing Practitioner Medical Doctor 130314 10/19/2026
GRISWOLD, AMY A Supervising Prescribing Practitioner Medical Doctor 67865 10/19/2026
HOLLAND, REUBEN WRIGHT III Supervising Prescribing Practitioner Medical Doctor 55507 10/19/2026
JAMES, RAYMOND A Supervising Prescribing Practitioner Osteopathic Physician 7168 10/19/2026
JOHNSON, MARK CHRISTOPHER Supervising Prescribing Practitioner Medical Doctor 82651 10/19/2026
JOHNSON, THOMAS BRIAN Supervising Prescribing Practitioner Medical Doctor 78286 10/19/2026
KALNOKY, ACHILLES Supervising Prescribing Practitioner Medical Doctor 115088 10/19/2026
KAMM, STEVEN WILLIAM M D Supervising Prescribing Practitioner Medical Doctor 56256 10/19/2026
KEITH, THOMAS ALAN Supervising Prescribing Practitioner Medical Doctor 111881 10/19/2026
KLEIN, JAMES EDUARD MD Supervising Prescribing Practitioner Medical Doctor 123723 10/19/2026
KRAHM, DAVID JOHN Supervising Prescribing Practitioner Osteopathic Physician 12583 10/19/2026
KRBLICH, DIANA NICOLE Supervising Prescribing Practitioner Medical Doctor 114055 10/19/2026
KUCHARSKI, ANDRZEJ Supervising Prescribing Practitioner Medical Doctor 80074 10/19/2026
LETTS, DAVID ANTHONY Supervising Prescribing Practitioner Medical Doctor 47494 10/19/2026
LOEFFLER, ARNO GERALD MD Supervising Prescribing Practitioner Medical Doctor 83650 10/19/2026
MAHONEY, WILLIAM MARK Supervising Prescribing Practitioner Medical Doctor 66743 10/19/2026
MASON, CLAUDE JOHN Supervising Prescribing Practitioner Medical Doctor 79271 10/19/2026
MEYER, JOHN WESTON JR Supervising Prescribing Practitioner Medical Doctor 57727 10/19/2026
MOUNTCASTLE, DANIEL JEFFREY Supervising Prescribing Practitioner Medical Doctor 36289 10/19/2026
MOZZETTI, MICHAEL DOMINIC MD Supervising Prescribing Practitioner Medical Doctor 69032 10/19/2026
NEWMAN, STEVEN ROBERT Supervising Prescribing Practitioner Medical Doctor 41050 10/19/2026
PATRICOSKI, CHRISTOPHER T Supervising Prescribing Practitioner Medical Doctor 112520 10/19/2026
PHELPS, DWIGHT STEPHEN MD Supervising Prescribing Practitioner Medical Doctor 83323 10/19/2026
SHREEVE, THOMAS Supervising Prescribing Practitioner Medical Doctor 94176 10/19/2026
SIMMONS, WALTER RAY D O Supervising Prescribing Practitioner Osteopathic Physician 9228 10/19/2026
SNITOWSKY, RYAN SCOTT Supervising Prescribing Practitioner Medical Doctor 120181 10/19/2026
STAHL, GREGORY Supervising Prescribing Practitioner Medical Doctor 91241 10/19/2026
STONE, DAVID D Supervising Prescribing Practitioner Medical Doctor 123376 10/19/2026
TEMPLE, SARAH RUTH Supervising Prescribing Practitioner Medical Doctor 111890 10/19/2026
TORRES, ANDRES JOSE Supervising Prescribing Practitioner Osteopathic Physician 9371 10/19/2026
WENDT, TARA LYNN Supervising Prescribing Practitioner Medical Doctor 117148 10/19/2026
WILLIAMS, ALEXANDER JON Supervising Prescribing Practitioner Medical Doctor 112278 10/19/2026
WILLIAMS, BRETT TUROS Supervising Prescribing Practitioner Medical Doctor 101891 10/19/2026

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner

Name Relationship Profession License Effective Date

Click on the License Number to view License Details for that Practitioner



No Continuing Education Hours Received from Approved Providers As Of 10/19/2026



* 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.