Provider First Line Business Practice Location Address:
CARR. 172 HOSPITAL SAN JUAN BAUTISTA
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-744-5888
Provider Business Practice Location Address Fax Number:
787-744-5892
Provider Enumeration Date:
07/18/2006