NPIMap

Organization Active NPI

PHM Multidisciplinary Clinic LLC

  • Specialist
  • Cabo Rojo, PR
National Provider Identifier
1285102269
Registry record updated Nov 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PHM MULTIDISCIPLINARY CLINIC LLC
Practice address
Galeria 100 Shopping Center Carretera 100 KM 6.6
Cabo Rojo, PR 00623
Phone
(787) 658-1389
Fax
(787) 658-1392
NPI assigned
Nov 7, 2018
Last updated
Nov 7, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PHM MULTIDISCIPLINARY CLINIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roberto Luis Bengoa
Title
Presidente
Phone
(787) 625-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

Galeria 100 Shopping Center Carretera 100 KM 6.6
Cabo Rojo, PR 00623

Mailing address

1551 Calle Alda Ste 201
San Juan, PR 00926-2709
Phone (787) 650-2732

Other names 1

  • Clinica de Cabo Rojo Other name

National Provider Directory

National Provider Directory
Tax ID family
PHM Multidisciplinary Clinic LLC8 organizations share this tax ID, including this one
Part of
PHM Multidisciplinary Clinic LLC

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1285102269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 CALLE ALDA STE 201",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009262709",
            "telephone_number": "787-650-2732",
            "fax_number": "787-650-2734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GALERIA 100 SHOPPING CENTER CARRETERA 100 KM 6.6",
            "city": "CABO ROJO",
            "state": "PR",
            "postal_code": "00623",
            "telephone_number": "787-658-1389",
            "fax_number": "787-658-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHM MULTIDISCIPLINARY CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHM MULTIDISCIPLINARY CLINIC LLC",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "BENGOA",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-625-2500"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinica de Cabo Rojo",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cabo Rojo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.