Provider First Line Business Practice Location Address:
PEDIATRIC UNIVERSITY HOSPITAL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
THIRD FLOOR
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00936-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-777-3535
Provider Business Practice Location Address Fax Number:
787-764-7004
Provider Enumeration Date:
09/12/2007