Provider Demographics
NPI:1790517951
Name:RAINBOW KIDS PEDIATRIC CARE, INC.
Entity type:Organization
Organization Name:RAINBOW KIDS PEDIATRIC CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:305-409-0862
Mailing Address - Street 1:16931 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4205
Mailing Address - Country:US
Mailing Address - Phone:786-633-6661
Mailing Address - Fax:
Practice Address - Street 1:3592 ALOMA AVE STE 67&8
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4012
Practice Address - Country:US
Practice Address - Phone:321-203-2152
Practice Address - Fax:321-972-1512
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAINBOW KIDS PEDIATRIC CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care