# PROFESSIONAL HEALTH CLINIC

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

## Provider details

- **NPI number:** 1578731865
- **Authorized official:** MR. IVAN MILLON (EJECUTIVE DIRECTOR)
- **Authorized official phone:** (787) 780-8454

## Contact information

- **Practice address:** 400 CALAF STREET, SUITE 361, SAN JUAN, PR 00918-1314
- **Practice address phone:** (787) 780-8454
- **Practice address fax:** (787) 779-2329
- **Mailing address:** 400 CALAF STREET, SUITE 361, SAN JUAN, PR 00918-1314
- **Mailing address phone:** (787) 780-8454
- **Mailing address fax:** (787) 779-2329

## Taxonomy

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

## Other

- **Enumeration date:** 02/20/2008
- **Last updated:** 04/20/2008