Provider First Line Business Practice Location Address:
PROFESSIONAL HOSPITAL MEDICAL PLAZA AV. LAS CUMBRES
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-223-5442
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2011