Provider First Line Business Practice Location Address:
CONDOMINIO MEDICOS DE DIEGO
Provider Second Line Business Practice Location Address:
DE DIEGO #14 ESTE OFIC.104
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-831-4040
Provider Business Practice Location Address Fax Number:
787-831-4005
Provider Enumeration Date:
01/30/2007