Provider First Line Business Practice Location Address:
#1051 CALLE 3 SE LA RIVIERA
Provider Second Line Business Practice Location Address:
COND MEDICAL CENTER PLAZA SUITE #13
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-749-9200
Provider Business Practice Location Address Fax Number:
787-790-1021
Provider Enumeration Date:
11/25/2005