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General NPI Number Information
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NPI Number | 1821426081
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Entity Type | Individual
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Provider Name | SHAUN MATTHEW RUDI CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/28/2013
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 1961 ZIENTARA LOOP
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City | THE VILLAGES
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State | FL
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Zip | 32163-5342
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Country | US
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Telephone | 803-530-5466
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Fax |
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Provider Business Mailing Address
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Address Line | 1961 ZIENTARA LOOP
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City | THE VILLAGES
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State | FL
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Zip | 32163-5342
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Country | US
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Telephone | 803-530-5466
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN0000031578
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN9446750
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 18843
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN2324800
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 201365
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License Number State | SC
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