Provider First Line Business Practice Location Address:
UPR-SOM MEDICAL SCIENCE CAMPUS DR JOSE CELSO BARBOSA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-2525
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2020