MEDICARE: SHANNON GRACE RUTTER M.S.

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	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1740727080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON GRACE RUTTER M.S.

Provider Business Mailing Address
First Line	:	2608 E CHURCH ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-6303
Country	:	US
Telephone Number	:	407-284-0103
Fax Number	:

Provider Business Practice Location Address
First Line	:	2608 E CHURCH ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-6303
Country	:	US
Telephone Number	:	407-284-0103
Fax Number	:

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

Provider Enumeration Date	:	01/25/2017
Last Update Date	:	01/25/2017

Similar Medicare Providers

1023950615 — REVIVAL HOME SUPPORT L.L.C
Practice Location Address:

8725 WELLESLEY LAKE DR APT 203
ORLANDO, FL
32818-6303

Practice Phone: 407-360-7309
Practice Fax:

1912849985 — REVIVAL HOME SUPPORT L.L.C
Practice Location Address:

8725 WELLESLEY LAKE DR APT 203
ORLANDO, FL
32818-6303

Practice Phone: 407-360-7309
Practice Fax:

1023728615 — JEAN HEROLD FONTIN
Practice Location Address:

8725 WELLESLEY LAKE DR APT 203
ORLANDO, FL
32818-6303

Practice Phone: 407-360-7309
Practice Fax:

1952155293 — WENSHELLE LUDGER
Practice Location Address:

6303 WESTGATE DR APT 2007
ORLANDO, FL
32835-7025

Practice Phone: 407-233-5526
Practice Fax:

1982580734 — RENAISSANCE HEALTHCARE GROUP LLC
Practice Location Address:

119 PASADENA PL
ORLANDO, FL
32803-3825

Practice Phone: 954-284-0495
Practice Fax:

1619411014 — RENAISSANCE HEALTHCARE GROUP LLC
Practice Location Address:

119 PASADENA PL
ORLANDO, FL
32803-3825

Practice Phone: 954-284-0495
Practice Fax:

Directions to “ SHANNON GRACE RUTTER M.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.