Provider First Line Business Practice Location Address:
EDIF MEDICO SANTA CRUZ
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-6910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-780-4095
Provider Business Practice Location Address Fax Number:
787-269-3147
Provider Enumeration Date:
03/17/2006