Provider First Line Business Practice Location Address:
130A PRIMER PISO
Provider Second Line Business Practice Location Address:
HOSPITAL HIMA- SAN PABLO OFIC.
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-653-3434
Provider Business Practice Location Address Fax Number:
787-744-1863
Provider Enumeration Date:
06/16/2006