Nidadavolu, Rekha

Nidadavolu, Rekha is an sole proprietor health care provider with primary practice located at 4745 Old Canoe Creek Rd , Saint Cloud FL 34769-1400. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Nidadavolu, Rekha can be contacted via phone (305) 905-9316.

Contact Information

Primary practice address
4745 Old Canoe Creek Rd Saint Cloud FL 34769-1400
Phone: (305) 905-9316
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X PS44664 Florida
Pharmacy Service Providers / Pharmacist 183500000X 24667 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA9111839 Florida

Profile Details

NPI number 1902138217
LBN Legal business name Nidadavolu, Rekha
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 11th, 2010
Last updated Jan 30th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902138217 NPPES
Massachusetts Other 24667 PHARMACIST LICENSE
Massachusetts Other PS44664 PHARMACIST LICENSE
Massachusetts Other PA9111839 PHARMACIST LICENSE

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