Individual
DR. NAGA LAKSHMANA PRASAD NIDADAVOLU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
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
ME109423
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003957500
—
FL
01
—
ME109423
FLORIDA MEDICAL BOARD
FL
Enumeration date
08/05/2007
Last updated
01/09/2025
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