Healthcare Provider Details

I. General information

NPI: 1194418590
Provider Name (Legal Business Name): SHI ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 OVERSEAS HWY
MARATHON FL
33050-2329
US

IV. Provider business mailing address

PO BOX 277615
MIRAMAR FL
33027-7615
US

V. Phone/Fax

Practice location:
  • Phone: 305-743-5533
  • Fax:
Mailing address:
  • Phone: 754-400-7496
  • Fax: 754-400-7492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RUDDY A VALDES
Title or Position: PRESIDENT
Credential: DO
Phone: 786-457-4900