Provider First Line Business Practice Location Address:
1394 CALLE SAN RAFAEL
Provider Second Line Business Practice Location Address:
DOCTOR'S MEDICAL PAVILION, SUITE 9
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909-2541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-724-3595
Provider Business Practice Location Address Fax Number:
787-724-0778
Provider Enumeration Date:
10/31/2006