Provider First Line Business Practice Location Address: 
AUXILIO CENTRO DE CANCER, 715 PONCE DE LEON AV
    Provider Second Line Business Practice Location Address: 
PARADA 37 1/2 ,EDIF. NINO JESUS 4TO PISO
    Provider Business Practice Location Address City Name: 
HATO REY
    Provider Business Practice Location Address State Name: 
PR
    Provider Business Practice Location Address Postal Code: 
00919
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
805-405-3660
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/17/2010