Provider First Line Business Practice Location Address:
917 AVE TITO CASTRO
Provider Second Line Business Practice Location Address:
SAINT LUKES MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00731-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-844-0705
Provider Business Practice Location Address Fax Number:
787-844-0706
Provider Enumeration Date:
02/07/2006