Provider First Line Business Practice Location Address:
CENTRO MEDICO DE PUERTO RICO
Provider Second Line Business Practice Location Address:
BO. MONACILLOS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-617-7363
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/02/2016