Provider First Line Business Practice Location Address:
184 CALLE GUADALUPE FINAL
Provider Second Line Business Practice Location Address:
ANTIGUO HOSPITAL SAN LUCAS
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-709-4130
Provider Business Practice Location Address Fax Number:
787-709-4134
Provider Enumeration Date:
07/02/2008