Provider First Line Business Practice Location Address:
CALLE SANTA CRUZ #68 TORRE SAN PABLO SUITE 306
Provider Second Line Business Practice Location Address:
CENTRO DERMATOLOGICO SAN PABLO PSC
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-798-2765
Provider Business Practice Location Address Fax Number:
787-740-1200
Provider Enumeration Date:
10/01/2008