Provider Demographics
NPI:1689989337
Name:OUR RAINBOW
Entity Type:Organization
Organization Name:OUR RAINBOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:REYNOLDS
Authorized Official - Last Name:ROLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-628-5384
Mailing Address - Street 1:16150 NW 40TH CT
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-6262
Mailing Address - Country:US
Mailing Address - Phone:305-628-5384
Mailing Address - Fax:
Practice Address - Street 1:16150 NW 40TH CT
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-6262
Practice Address - Country:US
Practice Address - Phone:305-628-5384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment