Provider First Line Business Practice Location Address:
BUEN SAMARITANO MEDICAL AND PROFESSIONAL PLAZA
Provider Second Line Business Practice Location Address:
TERCER PISO SUITE #11
Provider Business Practice Location Address City Name:
AGUADA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00602-4007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-422-2595
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2010