Provider First Line Business Practice Location Address:
HOSPITAL INDUSTRIAL 365028
Provider Second Line Business Practice Location Address:
CENTRO MEDICO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00936-5028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-398-9428
Provider Business Practice Location Address Fax Number:
787-282-7426
Provider Enumeration Date:
04/23/2012