Provider First Line Business Practice Location Address:
AVE JESUS T PINERO 1250 CAPARRA TERRACE
Provider Second Line Business Practice Location Address:
CENTRO OFTALMOLOGICO METROPOLITANO CSP
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:
787-781-2565
Provider Business Practice Location Address Fax Number:
787-782-9524
Provider Enumeration Date:
03/30/2006