LAKE CITY INSTITUTE OF NEUROLOGY PA
Neurology at American Ln, Lake City, FL

License number
Florida ME109423
Category
Neurology
Type
Neurology
Owner
Name: PRASAD NIDADAVOLU M.D.
Title: OWNER
Phone: (386) 755-1221
Address
Address
4355 NW American Ln, Lake City, FL 32055
National Provider ID: 1710266895
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about LAKE CITY INSTITUTE OF NEUROLOGY PA at bizstanding.com

Lake City Institute of Neurology, PA

4355 NW American Ln, Lake City, FL 32055

Registration:
Jul 18, 2011
State ID:
P11000064671
Business type:
Domestic for Profit Corporation
Director, President:
Nl Prasad M Nidadavolu (Director, President)
Agent:
Sheada Madani

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