Provider First Line Business Practice Location Address:
STREET 21 NUM. 1781
Provider Second Line Business Practice Location Address:
HOSP. METROPOLITANO 1-FLOOR SUITE 103
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:
787-783-6620
Provider Business Practice Location Address Fax Number:
787-793-8444
Provider Enumeration Date:
08/22/2006