Provider Demographics
NPI:1962908194
Name:RAINBOW RIVER HEARING & BALANCE, INC.
Entity type:Organization
Organization Name:RAINBOW RIVER HEARING & BALANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:GASCAY
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:352-462-7003
Mailing Address - Street 1:PO BOX 3293
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34430-3293
Mailing Address - Country:US
Mailing Address - Phone:352-462-7003
Mailing Address - Fax:833-252-6409
Practice Address - Street 1:20170 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:DUNNELLON
Practice Address - State:FL
Practice Address - Zip Code:34432-6032
Practice Address - Country:US
Practice Address - Phone:352-462-7003
Practice Address - Fax:352-496-3053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2077231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty