Provider First Line Business Practice Location Address:
CARR#2,MARGINAL#1,URB.SANTA RITA
Provider Second Line Business Practice Location Address:
EDIFICIO CARIBE MEDICAL PLAZA SUITE 101
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692-1360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-883-0915
Provider Business Practice Location Address Fax Number:
787-883-1085
Provider Enumeration Date:
12/29/2006