PHM MULTIDISCIPLINARY CLINIC LLC (NPI# 1720505548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720505548 |
| Entity Type | Organization |
| Organization Name | PHM MULTIDISCIPLINARY CLINIC LLC |
| Other Organization Name | CLINICA DE AGUADIILA |
| Practice Address |
Bo. Victoria Carretera 2 Km 129.3 Aguadilla PR 00603 |
| Mailing Address |
1551 Calle Alda San Juan PR 00926-2709 |
| Practice Telephone | 7876581389 |
| Practice Fax Number | 7876581392 |
| Mailing Telephone | 7876581389 |
| Mailing Fax Number | 7876581392 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | MR. WALESKA MARRERO (MEDICAL AND HEALTH SERVICES DIRECTO) |
| Authorized Official Telephone | 7874078764 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 405300000X | Prevention Professional | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Clinica De Aguadiila | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154899128 | Phm Multidisciplinary Clinic LLC | Specialist | B11 Calle 2, Urbanizacion Villa Real, Vega Baja, PR 00693 | 2018-11-08 |
| 1285102269 | Phm Multidisciplinary Clinic LLC | Specialist | Galeria 100 Shopping Center Carretera 100 Km 6.6, Cabo Rojo, PR 00623 | 2018-11-07 |
| 1174079537 | Phm Multidisciplinary Clinic LLC | Clinic/Center | 1551 Calle Alda, Suite 201, San Juan, PR 00926-2709 | 2016-08-26 |
| Street Address |
BO. VICTORIA CARRETERA 2 KM 129.3 |
| City | AGUADILLA |
| State | PR |
| Zip Code | 00603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255938593 | Natalia Cordero Lopez | Psychologist | 3 Calle Orquidea, Urb. La Victoria, Aguadilla, PR 00603 | 2020-10-08 |
| 1790390250 | Roberto Martinez Caballero | Physician Assistant | Carr#2 Km 141.1 Ave. Severiano Cuevas Bo Caimital Bajo, Aguadilla, PR 00603 | 2020-09-11 |
| 1427667906 | Northwestern Renal Care Psc | Exclusive Provider Organization | Edificio Western Plaza, Oficina 10, Ave. Severiano Cuevas 18, Carr 460 Km 1.2 Int, Aguadilla, PR 00603 | 2020-07-30 |
| 1457960502 | Tamara Paola Gonzalez Copo | Student in an Organized Health Care Education/Training Program | Bo Maleza Alta Sect Martinica Carr 110 Km32.3, Aguadilla, PR 00603 | 2020-07-24 |
| 1538778824 | Felipe Jose Soto | Student in an Organized Health Care Education/Training Program | Carr. 2 Km 141.1 Ave. Severiano Cuevas 18, Aguadilla, PR 00603 | 2020-07-23 |
| 1699383679 | Grisely Moro Acevedo | General Practice | Carr 110 Km 23.8 Int Reparto Monte Cristo 16, Bo. Ceiba Baja, Aguadilla, PR 00603 | 2020-07-16 |
| 1245857879 | Brunilda Rios | General Acute Care Hospital | Hospital Buen Samaritano Avenida Severiano Cuevas #18 K, Aguadilla, PR 00603 | 2020-06-30 |
| 1699391227 | Diannette Morales-crespo | General Practice | Avenida Severiano Cuevas, 18 Km 141.1 Bo. Caimital Bajo, Aguadilla, PR 00603 | 2020-06-19 |
| 1275158982 | Tamia Marie Lozada Soto | Student in an Organized Health Care Education/Training Program | Ave. Severiano Cuevas #18 Carr #2 Km 141.1, Aguadilla, PR 00603 | 2020-06-09 |
| 1679105902 | Super Heroes 5k Inc | Respite Care | Km 2.1 Road 107, Aguadilla Puerto Rico, Borinquen, Aguadilla, PR 00603 | 2020-02-05 |
| Find all providers in zip 00603 | ||||
| Taxonomy Code | 405300000X |
| Grouping | Other Service Providers |
| Classification | Prevention Professional |
| Prevention Professionals work in programs aimed to address specific patient needs, such as suicide prevention, violence prevention, alcohol avoidance, drug avoidance, and tobacco prevention. The goal of the program is to reduce the risk of relapse, injury, or re-injury of the patient. Prevention Professionals work in a variety of settings and provide appropriate case management, mediation, referral, and mentorship services. Individuals complete prevention professionals training for the population of patients with whom they work. |
| Notes: Source: National Uniform Claim Committee, 2015 [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467979286 | Phm Multidisciplinary Clinic, LLC | Prevention Professional | Bo San Daniel Km 81.3, Arecibo, PR 00612 | 2017-08-23 |
| 1700303526 | Phm Multidisiciplinary Clinic, LLC | Prevention Professional | Calle Palmer Esq Vicente Pales, Guayama, PR 00785 | 2017-08-23 |
| 1003332552 | Raul Correa | Prevention Professional | Calle 700 Manuel Pavia Street, Suite 301, San Juan, PR 00909 | 2017-08-16 |
| 1104342658 | Elizabeth Pabon Lugo | Prevention Professional | 700 Calle Doctor Pavia Fernandez, Suite 301, San Juan, PR 00909 | 2017-08-16 |
| 1013431147 | Stephanie Landrau Serrano | Prevention Professional | 700 Calle Dr Pavia Fernandez Ste 301, San Juan, PR 00909-2757 | 2017-07-31 |
| 1225564313 | Neishma Medina | Prevention Professional | 206 Calle Emeterio Hernandez, Paseo De Los Artesanos, Las Piedras, PR 00771-9671 | 2017-05-10 |
| 1225560212 | Centro De Vacunacion Sab | Prevention Professional | 5 Calle Pedro Albizu Campos, Aguas Buenas, PR 00703 | 2017-03-30 |
| 1225576580 | Maria Delgado | Prevention Professional | Carr. 600 Km 6.9, Angeles, PR 00611-0639 | 2017-02-07 |
| 1194184721 | Health Solution Corp | Prevention Professional | 1576 Villa Olimpica, San Juan, PR 00929-0000 | 2016-02-10 |
| 1952928228 | Joel Andres Rios Rodriguez | Prevention Professional | 388 Zona Ind Reparada 2, Ponce, PR 00716-2347 | 2020-07-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.