Provider First Line Business Practice Location Address:
HOSP AUXILLO MUTUO
Provider Second Line Business Practice Location Address:
AVE PONCE DE LEON
Provider Business Practice Location Address City Name:
HATA REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-765-7650
Provider Business Practice Location Address Fax Number:
787-766-4038
Provider Enumeration Date:
11/10/2005