Provider First Line Business Practice Location Address:
PUERTO RICO CHILDRENS HOSPITAL OFIC. 302
Provider Second Line Business Practice Location Address:
CARR NUM. 2 KM 11.7 EDIF. MEDICAL PLAZA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-474-5423
Provider Business Practice Location Address Fax Number:
787-523-2768
Provider Enumeration Date:
09/12/2005