Provider First Line Business Practice Location Address:
55 CALLE PALMA
Provider Second Line Business Practice Location Address:
SUSONI MEDICAL BUILDING, SUITE 101
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-4526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-4800
Provider Business Practice Location Address Fax Number:
787-817-1237
Provider Enumeration Date:
12/09/2005