MEDICARE: RAINBOW NEUROSCIENCE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PL817	OTHER	FL	PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235863721
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAINBOW NEUROSCIENCE LLC

Provider Business Mailing Address
First Line	:	3855 NE 168TH ST
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3523
Country	:	US
Telephone Number	:	305-423-9168
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 W HALLANDALE BEACH BLVD STE 104
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-5339
Country	:	US
Telephone Number	:	305-803-3695
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. LARISA ELBERG
Credential	:	MD
Telephone Number	:	305-423-9168

Provider Enumeration Date	:	07/12/2022
Last Update Date	:	04/06/2026

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