Provider Demographics
NPI:1518508985
Name:RODSKI, SYDNEY NICOLE (PA-C)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:NICOLE
Last Name:RODSKI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 STATE ST E STE A
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3666
Mailing Address - Country:US
Mailing Address - Phone:407-416-5314
Mailing Address - Fax:
Practice Address - Street 1:110 STATE ST E STE A
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3666
Practice Address - Country:US
Practice Address - Phone:727-799-9060
Practice Address - Fax:727-799-5314
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9112547363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant