Provider First Line Business Practice Location Address:
MEDICAL CENTER PLAZA NUM 2
Provider Second Line Business Practice Location Address:
CALLE CASIA ESQ 3SE
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-399-3255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/23/2024