Provider First Line Business Practice Location Address:
172 STREET KM 1.0
Provider Second Line Business Practice Location Address:
CENTRO DE SALUD FAMILIAR CIDRA
Provider Business Practice Location Address City Name:
CIDRA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00739-3030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-714-6600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2011