Provider First Line Business Practice Location Address:
SAN JUAN HEALTH CTR
Provider Second Line Business Practice Location Address:
SUITE 710, 150 DE DIEGO AVENUE
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:
787-647-7155
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/27/2006