Provider First Line Business Practice Location Address:
HOSPITAL HIMA-SAN PABLO, AVE. LUIS MUNOZ MARIN
Provider Second Line Business Practice Location Address:
SUITE 127-A
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-703-0806
Provider Business Practice Location Address Fax Number:
787-703-0806
Provider Enumeration Date:
10/24/2006