Provider First Line Business Practice Location Address:
EDIF MEDICO SANTA CRUZ
Provider Second Line Business Practice Location Address:
SUITE 311
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-6910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-798-3835
Provider Business Practice Location Address Fax Number:
787-798-4230
Provider Enumeration Date:
01/25/2007