Provider First Line Business Practice Location Address:
CARR # 2 AVE HOSTOS
Provider Second Line Business Practice Location Address:
# 410 HOSP RAMON E BETANCES CENTRO MEDICA DE MAYAGUEZ
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-806-2222
Provider Business Practice Location Address Fax Number:
787-806-2222
Provider Enumeration Date:
02/01/2006