Provider Demographics
NPI:1134658149
Name:GLG REHABILITATION CENTER,INC.
Entity Type:Organization
Organization Name:GLG REHABILITATION CENTER,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-640-5560
Mailing Address - Street 1:7171 CORAL WAY STE 100-505
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1449
Mailing Address - Country:US
Mailing Address - Phone:305-640-5560
Mailing Address - Fax:305-640-5294
Practice Address - Street 1:7171 CORAL WAY STE 100-505
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1449
Practice Address - Country:US
Practice Address - Phone:305-640-5560
Practice Address - Fax:305-640-5294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No251S00000XAgenciesCommunity/Behavioral Health