Provider First Line Business Practice Location Address:
CALLE 63 #123-1
Provider Second Line Business Practice Location Address:
CENTRO VACUNACION CAROLINA Y DRA LUCY MUNDO
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-238-6916
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2025