Provider First Line Business Practice Location Address:
CLINICA LAS AMERICAS ROOSEVELT AVENUE
Provider Second Line Business Practice Location Address:
SUITE 508
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-771-4800
Provider Business Practice Location Address Fax Number:
787-767-0685
Provider Enumeration Date:
08/11/2005