| Doctor Name: | SHELLEY ALLISON SANDIFORD |
| NPI Number: | 1578754958 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | TRN10897 |
| Business Practice Address: | 1619 W 5th Ave Gary, IN - 464041506 |
| Business Phone Number: | 2198864788 |
| Business Fax Number: | 2198864106 |
| Mailing Address: | 1301 Hodges Dr, TALLAHASSEE |
| State: | FL |
| Postal Code: | 323084614 |
| Phone Number: | 8504315714 |
| Fax Number: | 8504316403 |
| NPI Enumeration Date: | 08/09/2007 |
| NPI Last Update Date: | 07/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | TRN10897 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |