Provider First Line Business Practice Location Address:
201 CALLE GAUTIER BENITEZ
Provider Second Line Business Practice Location Address:
CONSOLIDATED MEDICAL PLAZA, SUITE 202
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725-5527
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-743-2128
Provider Business Practice Location Address Fax Number:
787-743-2128
Provider Enumeration Date:
06/12/2006