Provider First Line Business Practice Location Address:
SAN JUAN HEALTH CTR
Provider Second Line Business Practice Location Address:
150 DE DIEGO AVE SUITE 710
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-2300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-724-5831
Provider Business Practice Location Address Fax Number:
787-724-5109
Provider Enumeration Date:
05/20/2006