Provider First Line Business Practice Location Address:
AVE. DE DIEGO #150 SAN JUAN HEALTH CENTRE SUITE 607
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-721-8000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/29/2007