Provider First Line Business Practice Location Address:
H-43 FONT MARTIDLO AVE
Provider Second Line Business Practice Location Address:
HOSP. RYDER MEMORIAL
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-285-1106
Provider Business Practice Location Address Fax Number:
787-285-1105
Provider Enumeration Date:
10/12/2006