Provider First Line Business Practice Location Address:
SEVERIANO CUEVAS #18
Provider Second Line Business Practice Location Address:
HOSPITAL BUEN SAMARITANO
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00605-5261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-819-1925
Provider Business Practice Location Address Fax Number:
787-819-1928
Provider Enumeration Date:
04/15/2008