Organization
LAKE CITY INSTITUTE OF NEUROLOGY PA
Active
Other names
Florida Institute of Neurology
Organization subpart
No
Provider details
NPI number
Authorized official
REKHA NIDADAVOLU (ADMIN)
(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
2084N0400X
Neurology Physician
Primary
ME109423
FL
Other
Enumeration date
08/08/2011
Last updated
07/30/2024
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