PHM MULTIDISICIPLINARY CLINIC, LLC (NPI# 1700303526) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700303526 |
| Entity Type | Organization |
| Organization Name | PHM MULTIDISICIPLINARY CLINIC, LLC |
| Other Organization Name | CLINICA DE GUAYAMA |
| Practice Address |
Calle Palmer Esq Vicente Pales Guayama PR 00785 |
| Mailing Address |
1551 Calle Alda Urb Caribe Suite 201 San Juan PR 00926 |
| Practice Telephone | 7878661449 |
| Practice Fax Number | 7878665148 |
| Mailing Telephone | 7878661449 |
| Mailing Fax Number | 7878665148 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Authorized Official Name | MR. WALESKA MARRERO (MEDICAL AND HEATLH 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 Guayama | Other Name - Individual/Organization |
| Street Address |
CALLE PALMER ESQ VICENTE PALES |
| City | GUAYAMA |
| State | PR |
| Zip Code | 00785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174143317 | Omar Candelario Valdivieso | Nutritionist | Urb. Guayama Valley Street 15 H-11, Guayama, PR 00785 | 2020-04-17 |
| 1669001285 | Giancarlo Colon Rosa | Student in an Organized Health Care Education/Training Program | Urb San Martin D2-a, Guayama, PR 00785 | 2020-04-06 |
| 1942771381 | Andres Joffre Fraticelli Sr. | Social Worker | Urb. Villa Rosa I Calle 6 A17, Guayama, PR 00785 | 2018-12-11 |
| 1962993782 | Gabriel Omar Covas | General Practice | Calle 4 C-7, Urb. Rexmanor, Guayama, PR 00785 | 2018-05-29 |
| 1821510413 | Centro De Terapia Ocupacional Pediatrica Del Sureste LLC | Occupational Therapist | Ave Los Veteranos Calle 3, Guayama Medical Center, Guayama, PR 00785 | 2017-07-14 |
| 1922534742 | Jst Medical LLC | Registered Nurse | 1 Calle Palmer, Esquina Vicente Pales, Guayama, PR 00785 | 2017-05-11 |
| 1033659529 | Corp Fondo Del Seguro Del Estado | Clinic/Center | Carr 3 Km 0 Desvio Sur, Ave Pedro Albizu Campos, Guayama, PR 00785 | 2017-03-02 |
| 1881136000 | Mq Medical Plaza, Inc. | Clinic/Center | 1 Calle 1 350, Urbanizacion Villa Rosa, Guayama, PR 00785 | 2016-11-07 |
| 1427420090 | Brenda Liz Martinez | Nutritionist | Carr 3 Km 151.2, Bo. Coqui, Salinas, PR 00785 | 2015-10-22 |
| 1467854877 | Southeastern Healthcare Holdings LLC | Specialist | 1 Palmer Street Esq Vicente Pales, Bo Pueblo, Guayama, PR 00785 | 2014-09-17 |
| Find all providers in zip 00785 | ||||
| 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 |
| 1720505548 | Phm Multidisciplinary Clinic LLC | Prevention Professional | Bo. Victoria Carretera 2 Km 129.3, Aguadilla, PR 00603 | 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 | ||||
Please comment or provide details below to improve the information on PHM MULTIDISICIPLINARY CLINIC, LLC.
| 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.