Provider First Line Business Practice Location Address:
258 CALLE SAN JORGE SUITE 205
Provider Second Line Business Practice Location Address:
SAN JORGE CHILDREN HOSPITAL TOWER
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-433-7334
Provider Business Practice Location Address Fax Number:
787-727-6550
Provider Enumeration Date:
09/13/2005