Provider First Line Business Practice Location Address:
BUEN SAMARITANO, MEDICAL & PROFESSIONAL PLAZA
Provider Second Line Business Practice Location Address:
CARR. 460 KM. 1.2 INT. BO. CAIMITAL BAJO
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-814-0100
Provider Business Practice Location Address Fax Number:
321-206-8603
Provider Enumeration Date:
10/25/2016