Provider First Line Business Practice Location Address:
UNION # 10 ESQ. CELIS AGUILERA
Provider Second Line Business Practice Location Address:
FAJARDO MEDICAL PLAZA OFIC. 104
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-863-2236
Provider Business Practice Location Address Fax Number:
787-863-2236
Provider Enumeration Date:
08/17/2006