LAKE CITY INSTITUTE OF NEUROLOGY PA NPI 1710266895

NPI Information

NPI: 1710266895
Provider Name: LAKE CITY INSTITUTE OF NEUROLOGY PA
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
4355 NW AMERICAN LN
LAKE CITY, FL
ZIP 32055
Phone: (386) 755-1221
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LAKE CITY INSTITUTE OF NEUROLOGY PA is a neurology psychiatry neurology in Lake City, FL. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. LAKE CITY INSTITUTE OF NEUROLOGY PA NPI is 1710266895. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4355 NW AMERICAN LN
LAKE CITY, FL
ZIP 32055-828
Phone: (386) 755-1221
Fax: (386) 755-1219

The provider's authorized official is Prasad Nidadavolu .
The authorized official title is Owner and has the following contact phone number (386) 755-1221.

The enumeration date for this NPI number is 8/8/2011 and was last updated on 8/8/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	ME109423	FLORIDA	Yes

What is NPI?

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This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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