Ms Rekha Nidadavolu, PHYSICIAN ASSISTANT is a
Physician Assistant based in Saint Cloud, Florida. Ms Rekha Nidadavolu is licensed to practice in Florida (license number PA9111839) and her current practice location is
4745 Old Canoe Creek Rd, Saint Cloud, Florida. She can be reached at her office (for appointments etc.) via phone at
(305) 905-9316.
NPI number for Ms Rekha Nidadavolu is 1902138217 and her current mailing address is 4745 Old Canoe Creek Rd, Saint Cloud, Florida. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1902138217.
Healthcare Provider's Profile
| Full Name | Ms Rekha Nidadavolu |
|---|
| Gender | Female |
|---|
| Speciality | Physician Assistant |
|---|
| Location | 4745 Old Canoe Creek Rd, Saint Cloud, Florida |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1902138217
- Provider Enumeration Date: 02/11/2010
- Last Update Date: 01/30/2020
Medical Identifiers
Medical identifiers for Ms Rekha Nidadavolu such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902138217 | NPI | - | NPPES |
| 24667 | Other | MA | PHARMACIST LICENSE |
| PS44664 | Other | FL | FLORIDA BOARD OF PHARMACY |
| PA9111839 | Other | FL | FLORIDA PHYSICIAN ASSISTANT BOARD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | PS44664 (Florida) | Secondary |
| 183500000X | Pharmacist | 24667 (Massachusetts) | Secondary |
| 363A00000X | Physician Assistant | PA9111839 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Rekha Nidadavolu is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Rekha Nidadavolu, PHYSICIAN ASSISTANT
4745 Old Canoe Creek Rd,
Saint Cloud, FL 34769-1400
Ph: (305) 905-9316 | Ms Rekha Nidadavolu, PHYSICIAN ASSISTANT
4745 Old Canoe Creek Rd,
Saint Cloud, FL 34769-1400
Ph: (305) 905-9316 |
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