Provider First Line Business Practice Location Address: 
HOSPITAL PEDIATRICO UNIVERSITARIO
    Provider Second Line Business Practice Location Address: 
CENTRO MEDICO, CARRETERA 22, BO MONACILLOS
    Provider Business Practice Location Address City Name: 
RIO PIEDRAS
    Provider Business Practice Location Address State Name: 
PR
    Provider Business Practice Location Address Postal Code: 
00921
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
787-474-0333
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
08/27/2021