Provider Demographics
NPI:1366509671
Name:RAINBOW HEALTH CENTER INC
Entity Type:Organization
Organization Name:RAINBOW HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:ZULUETA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-388-0980
Mailing Address - Street 1:901A SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3206
Mailing Address - Country:US
Mailing Address - Phone:786-388-0980
Mailing Address - Fax:786-388-0981
Practice Address - Street 1:901A SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33174-3206
Practice Address - Country:US
Practice Address - Phone:786-388-0980
Practice Address - Fax:786-388-0981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7289174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC7289OtherAHCA LICENSE
FLK5247Medicare PIN