Provider First Line Business Practice Location Address:
STATE INSURANCE FUND
Provider Second Line Business Practice Location Address:
BOX 365028
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00936-5028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-282-7400
Provider Business Practice Location Address Fax Number:
787-767-3211
Provider Enumeration Date:
04/04/2007