Florida Institute Of Neurology | |
4745 Old Canoe Creek Rd Saint Cloud FL 34769-1400 | |
(407) 818-1664 | |
(407) 818-1654 |
Full Name | Florida Institute Of Neurology |
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Speciality | Psychiatry & Neurology |
Location | 4745 Old Canoe Creek Rd, Saint Cloud, Florida |
Authorized Official Name and Position | Rekha Nidadavolu (ADMIN) |
Authorized Official Contact | 3059059316 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Florida Institute Of Neurology 4745 Old Canoe Creek Rd Saint Cloud FL 34769-1400 Ph: (407) 818-1664 | Florida Institute Of Neurology 4745 Old Canoe Creek Rd Saint Cloud FL 34769-1400 Ph: (407) 818-1664 |
NPI Number | 1710266895 |
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Provider Enumeration Date | 08/08/2011 |
Last Update Date | 07/30/2024 |
Certification Date | 07/30/2024 |
Medicare PECOS PAC ID | 8628249935 |
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Medicare Enrollment ID | O20110919000097 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710266895 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | ME109423 (Florida) | Primary |
Provider Name | Naga Lakshmana Prasad Nidadavolu |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1386835601 PECOS PAC ID: 1557532710 Enrollment ID: I20110920000024 |
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