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Organization
NIDRA LLC
Active
Organization
NIDRA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAHUL KUMAR KAKKAR MD (CEO)
(904) 296-1300
Entity
Organization
Contact information
Practice address
9471 BAYMEADOWS ROAD, SUITE 101, JACKSONVILLE, FL 32256
(904) 296-1300
(904) 239-3066
Mailing address
6817 SOUTHPOINT PKWY, #802, JACKSONVILLE, FL 32216-6282
(904) 296-1300
(904) 239-3066
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
261Q00000X
Clinic/Center
ME79882
FL
Other
Enumeration date
08/23/2007
Last updated
12/19/2013
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