Provider Demographics
NPI:1912761917
Name:SHI SPECIALISTS LLC
Entity Type:Organization
Organization Name:SHI SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUDDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:754-400-7496
Mailing Address - Street 1:3600 RED RD STE 401
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6014
Mailing Address - Country:US
Mailing Address - Phone:138-662-7577
Mailing Address - Fax:
Practice Address - Street 1:524 W SAGAMORE AVE
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3514
Practice Address - Country:US
Practice Address - Phone:863-902-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-09
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty