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Organization
LAKE CITY INSTITUTE OF NEUROLOGY PA
Active
Organization
LAKE CITY INSTITUTE OF NEUROLOGY PA
Active
Other names
Florida Institute of Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REKHA NIDADAVOLU (MANAGER)
(305) 905-9316
Entity
Organization
Contact information
Practice address
4745 OLD CANOE CREEK RD, SAINT CLOUD, FL 34769-1400
(407) 818-1664
(407) 818-1654
Mailing address
4745 OLD CANOE CREEK RD, SAINT CLOUD, FL 34769-1400
(407) 818-1664
(407) 818-1654
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
—
NULL
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
02/17/2016
Last updated
01/09/2025
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