Organization
RAINBOW PEDIATRICS PC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AHMED REZK M.D. (OWNER)
(973) 356-6245
Entity
Organization
Contact information
Practice address
200 FOREST PARK CIR, PANAMA CITY, FL 32405-4915
(850) 257-5524
(850) 257-5638
Mailing address
PO BOX 578, LYNN HAVEN, FL 32444-0578
(850) 767-4777
(850) 763-4988
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME105520
FL
2080A0000X
Pediatric Adolescent Medicine Physician
ME105520
FL
2080N0001X
Neonatal-Perinatal Medicine Physician
ME105520
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008959200
—
FL
Enumeration date
06/25/2013
Last updated
09/23/2021
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