Provider First Line Business Practice Location Address: 
151 AVE OSVALDO MOLINA
    Provider Second Line Business Practice Location Address: 
CARIBBEAN MEDICAL CENTER
    Provider Business Practice Location Address City Name: 
FAJARDO
    Provider Business Practice Location Address State Name: 
PR
    Provider Business Practice Location Address Postal Code: 
00738
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
787-801-0081
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
03/05/2025