Provider First Line Business Practice Location Address:
550 CALLE CONCEPCION VERA AYALA
Provider Second Line Business Practice Location Address:
HOSPITAL SAN CARLOS BORROMEO 1ER PISO
Provider Business Practice Location Address City Name:
MOCA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00676-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-551-0215
Provider Business Practice Location Address Fax Number:
787-551-0214
Provider Enumeration Date:
11/30/2009