Provider Demographics
NPI:1275256679
Name:LINARES, SHINIKA LALTOYA
Entity Type:Individual
Prefix:
First Name:SHINIKA
Middle Name:LALTOYA
Last Name:LINARES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 MICHELLE ST
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-6335
Mailing Address - Country:US
Mailing Address - Phone:229-488-2691
Mailing Address - Fax:
Practice Address - Street 1:4817 MICHELLE ST
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-6335
Practice Address - Country:US
Practice Address - Phone:229-488-2691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor