Provider First Line Business Practice Location Address:
2225 PONCE BY PASS SUITE 902
Provider Second Line Business Practice Location Address:
PARRA MEDICAL PLAZA
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-841-1501
Provider Business Practice Location Address Fax Number:
787-812-0910
Provider Enumeration Date:
11/15/2013