Provider First Line Business Practice Location Address:
TORRE MEDICA SAN LUCAS, AVE. TITO CASTRO 917
Provider Second Line Business Practice Location Address:
SUITE 618
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-290-3333
Provider Business Practice Location Address Fax Number:
787-290-4444
Provider Enumeration Date:
11/16/2006