Organization
LYERLY BAPTIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWNE BYSHEIM (EXECUTIVE DIRECTOR)
(631) 786-6094
Entity
Organization
Contact information
Practice address
8595 SAINT JOHNS PKWY STE B203, ST AUGUSTINE, FL 32092-2064
(904) 202-6683
(904) 376-3062
Mailing address
PO BOX 746647, ATLANTA, GA 30374-6647
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0106X
Orthopaedic Hand Surgery Physician
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/16/2026
Last updated
06/16/2026
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