Provider First Line Business Practice Location Address:
HOSPITAL PEDIATRICO DR ANTONIO ORTIZ
Provider Second Line Business Practice Location Address:
BO. MONACILLOS ST. 22 PUERTO RICO MEDICAL CENTER
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:
787-777-3535
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2013