Provider Demographics
NPI:1699507004
Name:CARDENAS, SANDRA L (RD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16941 NW 42ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33055-4405
Mailing Address - Country:US
Mailing Address - Phone:786-393-9037
Mailing Address - Fax:
Practice Address - Street 1:16941 NW 42ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33055-4405
Practice Address - Country:US
Practice Address - Phone:786-393-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered