RAINBOW PEDIATRICS PC LLC (NPI# 1134569049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134569049 |
| Entity Type | Organization |
| Organization Name | RAINBOW PEDIATRICS PC LLC |
| Practice Address |
2905 Highway 77 Panama City FL 32405-5013 |
| Mailing Address |
Po Box 578 Lynn Haven FL 32444-0578 |
| Practice Telephone | 8502575524 |
| Practice Fax Number | 8502575638 |
| Mailing Telephone | 8507674777 |
| Mailing Fax Number | 8507634988 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2014-02-10 |
| Authorized Official Name | DR. AHMED REZK (OWNER) |
| Authorized Official Telephone | 9733566245 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
ME105520 | FL | Allopathic & Osteopathic Physicians |
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
ME105520 | FL | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | ME105520 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 008959200 | 05 |
| Street Address |
2905 HIGHWAY 77 |
| City | PANAMA CITY |
| State | FL |
| Zip Code | 32405-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861458424 | Phillip Wayne Blaich | Physician Assistant | 2905 Highway 77, Panama City, FL 32405 | 2006-04-24 |
| 1679027254 | Janie Pitts | Nurse Practitioner | 2905 Highway 77, Panama City, FL 32405-5013 | 2016-08-11 |
| 1629448543 | Tiffany Brenda Joy Roberts | Nurse Practitioner | 2905 Highway 77, Panama City, FL 32405-5013 | 2015-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457962136 | Kimberlea Fox | Behavioral Analyst | 4750 Collegiate Drive, Technology Building 157, Panama City, FL 32405 | 2020-08-14 |
| 1598325714 | Covenant Home Health Care, LLC | Home Health | 107 W. 19th Street, Panama City, FL 32405 | 2019-06-19 |
| 1467921403 | Amy Hancock | Counselor | 1212 W. 19th St., Panama City, FL 32405 | 2018-11-20 |
| 1063991917 | Patricia Kagendo Mutunga | Day Training, Developmentally Disabled Services | 2813 Fairmont Dr, Panama City, FL 32405 | 2018-08-11 |
| 1871087882 | Southeastern Dermatology Group Pa | Pharmacy | 2505 Harrison Ave Ste A, Panama City, FL 32405 | 2018-06-22 |
| 1346733615 | Jessica Nicole Graham | Nurse Practitioner | 2507 Harrison Ave Unit 101, Panama City, FL 32405 | 2018-06-12 |
| 1437658424 | Coastal Mobility Transportation, LLC | Non-emergency Medical Transport (VAN) | 203 Forest Park Circle, Panama City, FL 32405 | 2018-02-06 |
| 1003314915 | The Anti-aging Clinic of Northwest Florida | Obstetrics & Gynecology | 3019 Osprey Cir, Panama City, FL 32405 | 2018-01-25 |
| 1255848487 | Sarah Theriot | Social Worker | 700 W 23rd St Bldg H, Panama City, FL 32405 | 2018-01-09 |
| 1336686054 | Angela Leake | Registered Nurse | 449 W 23 St, Panama City, FL 32405 | 2017-01-20 |
| Find all providers in zip 32405 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518498054 | Jordan Rutherford | Pediatrics | 528 W Baldwin Rd Unit A, Panama City, FL 32405-3313 | 2017-03-26 |
| 1447681804 | House Call Pediatrics | Pediatrics | 625 W Baldwin Rd Ste B, Panama City, FL 32405-3359 | 2013-12-10 |
| 1467761262 | Pediatric Group | Pediatrics | 2420 Jenks Ave Unit 3, Panama City, FL 32405-4910 | 2010-09-28 |
| 1881808921 | Aimee R Bohn | Pediatrics | 2933 Highway 77, Panama City, FL 32405 | 2007-05-09 |
| 1730275215 | Mohammed Abdul Rahim | Pediatrics | 340 West 23rd St, Suite K, Panama City, FL 32405 | 2006-10-04 |
| 1689639114 | Rubina Azam | Pediatrics | 528 W Baldwin Rd, Panama City, FL 32405-3313 | 2006-04-18 |
| 1003897620 | Mohammed Yahia Abdul-rahim | Pediatrics | 200 W 19th St, Panama City, FL 32405-4628 | 2005-11-10 |
| 1861492829 | Marjorie Lee Barnett | Pediatrics | 449 West 23rd St, Panama City, FL 32405 | 2005-07-29 |
| 1801453865 | Ashraf K Abdelhemid | Pediatrics | 748 Harrison Ave, Panama City, FL 32401-2524 | 2019-05-24 |
| 1730532763 | Yaslam Balfaqih | Pediatrics | 621 W Baldwin Rd, Panama City, FL 32405-3364 | 2016-07-14 |
| Find all providers in PANAMA CITY | ||||
| City | PANAMA CITY |
| Zip Code | 32405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.