Provider First Line Business Practice Location Address:
UNIVERSITY PEDIATRIC HOSPITAL
Provider Second Line Business Practice Location Address:
PURTO RICO MEDICAL CENTER
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-777-3535
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2006