Provider First Line Business Practice Location Address:
CALLE JOSE FERNANDEZ #6
Provider Second Line Business Practice Location Address:
4 TO PISO EDIT FERNANDEZ MEDICAL BUILDING
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-998-0639
Provider Business Practice Location Address Fax Number:
787-998-4516
Provider Enumeration Date:
01/04/2012