Healthcare Provider Details

I. General information

NPI: 1073900064
Provider Name (Legal Business Name): SHAWN SINGH RAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 SE 28TH LOOP
OCALA FL
34471-5323
US

IV. Provider business mailing address

2050 SW 76TH LN
OCALA FL
34476-6768
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-1743
  • Fax:
Mailing address:
  • Phone: 561-714-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number91814
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME162703
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: