Provider First Line Business Practice Location Address:
HOSPITAL HIMA- SAN PABLO
Provider Second Line Business Practice Location Address:
AVE GENERAL VALERO # 404
Provider Business Practice Location Address City Name:
FAJARDO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-655-0505
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/31/2006