Provider First Line Business Practice Location Address:
MED CARIBE IPA 514
Provider Second Line Business Practice Location Address:
AVE. ROOSEVELT 1028
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00920
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-706-8705
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2023