MEDICARE: RUDILYN SHIVJI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	APRN11045194	FL

General Provider Information

NPI Number	:	1194676130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUDILYN SHIVJI

Provider Business Mailing Address
First Line	:	3100 WESTON RD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 WESTON RD
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33331-3602
Country	:	US
Telephone Number	:	914-707-2163
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “ RUDILYN SHIVJI ” Practice Location

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