Provider First Line Business Practice Location Address:
909 AVE TITO CASTRO
Provider Second Line Business Practice Location Address:
TORRE MEDICA HOSPITAL SAN LUCAS SUITE 105
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00716-0105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-651-1435
Provider Business Practice Location Address Fax Number:
787-651-6362
Provider Enumeration Date:
06/03/2016