MEDICARE: RAINBOW PHYSICAL THERAPY CENTER 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	261QR0400X	Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1083418412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAINBOW PHYSICAL THERAPY CENTER LLC

Provider Business Mailing Address
First Line	:	4688 PALM AVE UNIT A
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4036
Country	:	US
Telephone Number	:	305-224-0812
Fax Number	:	305-224-0697

Provider Business Practice Location Address
First Line	:	4688 PALM AVE UNIT A
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4036
Country	:	US
Telephone Number	:	305-224-0812
Fax Number	:	305-224-0697

Authorized Official
Title or Position	:	OWNER
Name	:	ELIZABETH DE LA CRUZ RIZZO
Credential	:
Telephone Number	:	305-224-0812

Provider Enumeration Date	:	04/03/2025
Last Update Date	:	08/18/2025

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