Basic Information
| Provider Information | |||||||||
| NPI: | 1932637485 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JONES | ||||||||
| FirstName: | SANDREKA | ||||||||
| MiddleName: | SHENEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1395 NW 167TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI GARDENS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331695710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044549020 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4710 S CARROLLTON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701196027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044549020 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/31/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 213E00000X | 003105 | NY | N | Podiatric Medicine & Surgery Service Providers | Podiatrist | 213E00000X | 324888 | LA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist |
No ID Information.