Provider Demographics
NPI:1952180861
Name:STEPHENSON, SYDNEY MARIE
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:MARIE
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14661 US HIGHWAY 1 LOT 70
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1114
Mailing Address - Country:US
Mailing Address - Phone:561-271-5288
Mailing Address - Fax:
Practice Address - Street 1:14661 US HIGHWAY 1 LOT 70
Practice Address - Street 2:
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1114
Practice Address - Country:US
Practice Address - Phone:561-271-5288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant