Provider First Line Business Practice Location Address:
BO MONACILLO CENTRO MEDICO DE PUERTO RICO
Provider Second Line Business Practice Location Address:
HOSPITAL SAN JUAN DEPT DE PEDIATRIA 3ER NIVEL
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-637-1373
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/29/2014