Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Rekha Nidadavolu, PHYSICIANASSISTANT

Individual provider Pharmacist · NPI 1902138217

MS. Rekha Nidadavolu, PHYSICIANASSISTANT is a Pharmacist in Saint Cloud, Florida. Practices as a sole proprietor. Licensed in Florida and Massachusetts.

Licensed in
FL, MA
In the registry since
2010
Specialties on file
3
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Practice location Address checks out

4745 Old Canoe Creek Rd
Saint Cloud, FL 34769-1400
Phone: (305) 905-9316
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9111839 (FL)
Pharmacist Taxonomy 183500000X · Licence PS44664 (FL)
Pharmacist Taxonomy 183500000X · Licence 24667 (MA)

Record details

NPI number1902138217
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedFebruary 11, 2010
Last updated in NPPESJanuary 30, 2020
Certification dateJanuary 30, 2020

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