Provider First Line Business Practice Location Address:
ROOSEVELT AVE. CLINICA LAS AMERICAS
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-777-1163
Provider Business Practice Location Address Fax Number:
787-777-1164
Provider Enumeration Date:
05/14/2013