Provider Demographics
NPI:1871480947
Name:LYTLE, SYDNIE LEE (PA-C)
Entity type:Individual
Prefix:
First Name:SYDNIE
Middle Name:LEE
Last Name:LYTLE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 FAIRWAY PARK BLVD UNIT 906
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2622
Mailing Address - Country:US
Mailing Address - Phone:904-583-6033
Mailing Address - Fax:904-583-6033
Practice Address - Street 1:4500 SAN PABLO RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-1865
Practice Address - Country:US
Practice Address - Phone:904-953-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-21
Last Update Date:2025-06-21
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant