# PHM MULTIDISCIPLINARY CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174079537
- **Authorized official:** WALESKA MARRERO LCDA (MEDICAL AND HEALTH SERVICES DIRECTO)
- **Authorized official phone:** (717) 407-8764

## Contact information

- **Practice address:** 1551 CALLE ALDA, SUITE 201, SAN JUAN, PR 00926-2709
- **Practice address phone:** (787) 625-2500
- **Practice address fax:** (787) 625-0294
- **Mailing address:** 1551 CALLE ALDA SUITE 201 URB. CARIBE, SAN JUAN, PR 00926-2709
- **Mailing address phone:** (787) 650-2732
- **Mailing address fax:** (787) 650-2734

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/26/2016
- **Last updated:** 12/08/2017