Provider First Line Business Practice Location Address:
CARRETERA #22 CENTRO MEDICO DE PUERTO RICO
Provider Second Line Business Practice Location Address:
BO. MONACILLOS
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-754-2525
Provider Business Practice Location Address Fax Number:
787-282-7426
Provider Enumeration Date:
05/25/2012