Provider First Line Business Practice Location Address:
400 ROOSEVELT AVE.
Provider Second Line Business Practice Location Address:
CLINICA LAS AMERICAS, SUITE 101
Provider Business Practice Location Address City Name:
HATOREY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-2129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-765-7713
Provider Business Practice Location Address Fax Number:
787-250-7967
Provider Enumeration Date:
12/23/2005