| Rainbow Neuroscience Llc | |
|
11750 Sw 40th St Miami FL 33175-3530 | |
| (305) 223-3000 | |
| Not Available |
| Full Name | Rainbow Neuroscience Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 11750 Sw 40th St, Miami, Florida |
| Authorized Official Name and Position | Larisa B Elberg (PRESIDENT /OWNER) |
| Authorized Official Contact | 3058033695 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rainbow Neuroscience Llc 3855 Ne 168th St North Miami Beach FL 33160-3523 Ph: (305) 423-9168 | Rainbow Neuroscience Llc 11750 Sw 40th St Miami FL 33175-3530 Ph: (305) 223-3000 |
| NPI Number | 1235863721 |
|---|---|
| Provider Enumeration Date | 07/12/2022 |
| Last Update Date | 07/12/2022 |
| Certification Date | 07/10/2022 |
| Medicare PECOS PAC ID | 2163804808 |
|---|---|
| Medicare Enrollment ID | O20220728000302 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235863721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Larisa B Elberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295782209 PECOS PAC ID: 0143256768 Enrollment ID: I20050714000294 |
| Provider Name | Francisco Robert Coronado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184337818 PECOS PAC ID: 2163889262 Enrollment ID: I20230606000158 |
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