Provider First Line Business Practice Location Address:
1ER PISO, CENTRO MEDICO DE PUERTO RICO
Provider Second Line Business Practice Location Address:
EDIF. DECANATO DE ESTUDIANTES
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-773-8283
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2020