LAKE CITY INSTITUTE OF NEUROLOGY PA — NPI 1578922613 (Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) in SAINT CLOUD, FL)

CMS-1500 Box 24J / 33a • NPI

1578922613

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

2084N0008X (CMS 86)

Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)

Box 32 Service Location & ZIP+4

4745 OLD CANOE CREEK RD, SAINT CLOUD, FL, 34769-1400

✓ 9-Digit EDI 837 ZIP+4 (34769-1400)

Practice Phone & Referral Fax

(407) 818-1664

Fax: (407) 818-1654

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1578922613 (LAKE CITY INSTITUTE OF NEUROLOGY PA) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1578922613` (NPI-2 Organization / Facility)
Provider / Legal Name	LAKE CITY INSTITUTE OF NEUROLOGY PA
Plain-English Specialty	Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) NUCC Code: `2084N0008X` (Psychiatry & Neurology, Neuromuscular Medicine)
Certifying / Licensing Body	American Board of Psychiatry and Neurology (ABPN)
Practice Location Address	4745 OLD CANOE CREEK RD, SAINT CLOUD, FL, 34769-1400
Practice Telephone / Fax	Tel: (407) 818-1664 \| Fax: (407) 818-1654
Administrative Mailing Address	4745 OLD CANOE CREEK RD, SAINT CLOUD, FL, 34769-1400
Enumeration & Last Sync	Enumerated: 2016-02-17 \| CMS Record Updated: 2025-01-09
Authorized Official	REKHA NIDADAVOLU (Manager)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

4745 OLD CANOE CREEK RD, SAINT CLOUD, FL, 34769-1400

🗺️ Open in Google Maps 🏥 More Providers in SAINT CLOUD

🔒 Are you LAKE CITY INSTITUTE OF NEUROLOGY PA? Get your Verified NPI Clinic Badge or request personal phone/address redaction →

Plain-English Taxonomy & CMS Crosswalk (2084N0008X)

What Does Taxonomy Code 2084N0008X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2084N0008X translates to:
"Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 86 (Physician/Neuropsychiatry)
Certifying / Accrediting Authority: American Board of Psychiatry and Neurology (ABPN)
Clinical Scope: Stroke recovery, chronic or severe migraines, seizures, numbness/tingling in hands or feet (neuropathy), tremors, memory loss, or suspected CSF leak.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LAKE CITY INSTITUTE OF NEUROLOGY PA)

Typical CPT / Diagnostic Procedures:

Electroencephalography (EEG — CPT 95816) for Seizure & Epilepsy Evaluation
Electromyography (EMG) & Nerve Conduction Studies (NCS)
Lumbar Puncture & Cerebrospinal Fluid (CSF) Pressure/Analysis
Acute Ischemic Stroke NIHSS Assessment & Neuroimaging Review

Common Therapeutic Classes:

CGRP Antagonists & Triptans (Sumatriptan, Rizatriptan) for Migraine
Antiepileptic Drugs (Levetiracetam, Lamotrigine, Valproate)
Levodopa/Carbidopa (Parkinson's Disease) & Gabapentin/Pregabalin (Neuropathy)
Antiplatelet & Secondary Stroke Prevention Regimens

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`2084N0008X` — Psychiatry & Neurology, Neuromuscular Medicine Plain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist)	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

Batch-verify up to 25 NPIs free against CMS NPPES + Medicare PECOS + HHS OIG Exclusions with 1-click CSV export.

Launch Bulk NPI Checker → JSON API Docs

LAKE CITY INSTITUTE OF NEUROLOGY PA (NPI #1578922613)