# PHM MULTIDISCIPLINARY CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clinica De Aguadiila
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720505548
- **Authorized official:** MR. WALESKA MARRERO (MEDICAL AND HEALTH SERVICES DIRECTO)
- **Authorized official phone:** (787) 407-8764

## Contact information

- **Practice address:** BO. VICTORIA CARRETERA 2 KM 129.3, AGUADILLA, PR 00603
- **Practice address phone:** (787) 658-1389
- **Practice address fax:** (787) 658-1392
- **Mailing address:** 1551 CALLE ALDA, SAN JUAN, PR 00926-2709
- **Mailing address phone:** (787) 658-1389
- **Mailing address fax:** (787) 658-1392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 405300000X | Prevention Professional | — | — | Yes |

## Other

- **Enumeration date:** 08/23/2017
- **Last updated:** 08/23/2017