Healthcare Provider Details

I. General information

NPI: 1093609034
Provider Name (Legal Business Name): OLVG CONSULTING GROUP CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 NW 183RD ST STE 239B
MIAMI FL
33169-4559
US

IV. Provider business mailing address

99 NW 183RD ST STE 239B
MIAMI FL
33169-4559
US

V. Phone/Fax

Practice location:
  • Phone: 305-713-7457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LUIS L MAS
Title or Position: PRESIDENT
Credential: MD
Phone: 305-713-7457