Provider Demographics
NPI:1588019962
Name:JOHN, REENA SARAH (DO,)
Entity Type:Individual
Prefix:MS
First Name:REENA
Middle Name:SARAH
Last Name:JOHN
Suffix:
Gender:F
Credentials:DO,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W ESPLANADE AVE # 232
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2570
Mailing Address - Country:US
Mailing Address - Phone:504-229-4866
Mailing Address - Fax:504-229-4860
Practice Address - Street 1:20900 BISCAYNE BLVD
Practice Address - Street 2:SUITE 480
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1407
Practice Address - Country:US
Practice Address - Phone:305-682-5293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL390200000X
LA322089207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program