Provider Demographics
NPI:1255149233
Name:OG REHABILITATION CENTER CORP
Entity type:Organization
Organization Name:OG REHABILITATION CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIUSMALKYS
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR VALENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-565-1551
Mailing Address - Street 1:85 GRAND CANAL DR STE 404
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2571
Mailing Address - Country:US
Mailing Address - Phone:305-565-1551
Mailing Address - Fax:
Practice Address - Street 1:85 GRAND CANAL DR STE 404
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2571
Practice Address - Country:US
Practice Address - Phone:305-565-1551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center