License Verification

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DOMENIC DEROBERTIS

License Number: AA698

Data As Of 12/2/2024

Profession
Anesthesiologist Assistant
License
AA698
License Status
CLEAR/Active
License Expiration Date
1/31/2025
License Original Issue Date
12/06/2021
Address of Record
21260 Olean Blvd
PORT CHARLOTTE, FL 33952
Discipline on File
No
Public Complaint
No

No secondary locations found.


Name Relationship Profession License Effective Date
ALLEE, JOY SUPERVISOR for AA Medical Doctor 107342 04/01/2022
ALLEE, JOY Supervising ME Medical Doctor 107342 04/01/2022
BERG, RENATA J SUPERVISOR for AA Medical Doctor 102125 04/01/2022
CABREJA, RAMON FIDEL Supervising ME Medical Doctor 64355 10/21/2024
DENNY, JOHN T SUPERVISOR for AA Medical Doctor 142659 04/01/2022
DENNY, JOHN T Supervising ME Medical Doctor 142659 04/01/2022
ECHAVARRIA, GONZALO Supervising ME Medical Doctor 94847 10/21/2024
HARTENBACH, WILLIAM NORBERT Supervising ME Medical Doctor 56245 04/01/2022
LENTZ, JEFFREY MITCHELL M D Supervising ME Medical Doctor 69159 11/06/2024
LIU, SHAOXIONG Supervising ME Medical Doctor 154021 04/01/2022
MYRICK BREWER, CAROL J MD SUPERVISOR for AA Medical Doctor 67348 04/01/2022
MYRICK BREWER, CAROL J MD Supervising ME Medical Doctor 67348 04/01/2022
OZKUM, KENT ZIYA Supervising ME Medical Doctor 144966 04/01/2022
PALMERI, SHAWN ROBERT SUPERVISOR for AA Medical Doctor 139346 04/01/2022
PALMERI, SHAWN ROBERT Supervising ME Medical Doctor 139346 04/01/2022
POLLIZZI, ANTHONY MD SUPERVISOR for AA Medical Doctor 55771 04/01/2022
POLLIZZI, ANTHONY MD Supervising ME Medical Doctor 55771 04/01/2022
RUST, DAVID G M D SUPERVISOR for AA Medical Doctor 133226 04/01/2022
RUST, DAVID G M D Supervising ME Medical Doctor 133226 04/01/2022
SILLART, DOUGLAS RICHARD SUPERVISOR for AA Medical Doctor 144682 04/01/2022
SILLART, DOUGLAS RICHARD Supervising ME Medical Doctor 144682 04/01/2022
SMITH, DANIEL P SUPERVISOR for AA Medical Doctor 98899 04/01/2022
SMITH, DANIEL P Supervising ME Medical Doctor 98899 04/01/2022
SZLABOWICZ, MICHAL RAFAL Supervising ME Medical Doctor 80851 10/21/2024
VAN FOSSEN, LARRY DOUGLAS SUPERVISOR for AA Osteopathic Physician 18532 04/01/2022

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Name Relationship Profession License Effective Date

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Name Relationship Profession License Effective Date

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No Continuing Education Hours Received from Approved Providers As Of 12/2/2024



* 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.