Provider First Line Business Practice Location Address:
1324 CALLE CANADA
Provider Second Line Business Practice Location Address:
ANTIGUO HOSPITAL VETERANO PUERTO NUEVO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00920-3860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-793-1554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2007