Provider Demographics
NPI:1316736135
Name:SYSA, LIUDMYLA (MD)
Entity type:Individual
Prefix:
First Name:LIUDMYLA
Middle Name:
Last Name:SYSA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 HUNTERS LAKE WAY APT 7106
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32081-0188
Mailing Address - Country:US
Mailing Address - Phone:904-678-3020
Mailing Address - Fax:
Practice Address - Street 1:430 HUNTERS LAKE WAY APT 7106
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32081-0188
Practice Address - Country:US
Practice Address - Phone:904-678-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No251E00000XAgenciesHome Health