Healthcare Provider Details

I. General information

NPI: 1568098143
Provider Name (Legal Business Name): RLGC SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11750 SW 40TH ST
MIAMI FL
33175-3530
US

IV. Provider business mailing address

17153 SW 149TH PL
MIAMI FL
33187-6733
US

V. Phone/Fax

Practice location:
  • Phone: 786-263-2494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RAMONA LUISA GOMEZ CASTELLANOS
Title or Position: PRESIDENT
Credential:
Phone: 786-263-2494