Nicolas Lyde, PA Valid NPI

Individual provider · Physician Assistant · South Pasadena, FL

NPI

1104986355

Type

Individual (Type 1)

Primary specialty

Physician Assistant

Specialty group

Physician Assistants & Advanced Practice Nursing Providers

Taxonomy code

363A00000X

License number

PA3024 (FL)

Sex

Male

Sole proprietor

No

Enumerated

2006-12-11

Last updated

2007-07-08