Provider First Line Business Practice Location Address:
HOSPITAL AUXILIO MUTUO - 1ER PISO EDIF. SAN VICENTE
Provider Second Line Business Practice Location Address:
735 AVE. PONCE DE LEON, PARADA 37 1/2
Provider Business Practice Location Address City Name:
HATO REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-3320
Provider Business Practice Location Address Fax Number:
787-758-3358
Provider Enumeration Date:
09/20/2006