Provider First Line Business Practice Location Address:
1785 CARR 21
Provider Second Line Business Practice Location Address:
HOSPITAL METROPOLITANO SUITE 202
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-3399
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-781-5153
Provider Business Practice Location Address Fax Number:
787-793-8341
Provider Enumeration Date:
03/02/2006