Provider First Line Business Practice Location Address:
PAVIA MEDICAL PLAZA, SUITE 103
Provider Second Line Business Practice Location Address:
611 CALLE MANUEL PAVIA
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-727-3745
Provider Business Practice Location Address Fax Number:
787-726-2026
Provider Enumeration Date:
08/22/2006