Provider First Line Business Practice Location Address:
SAN JUAN HEALTH CENTER BLDG
Provider Second Line Business Practice Location Address:
150 AVE DE DIEGO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-761-0036
Provider Business Practice Location Address Fax Number:
787-292-5050
Provider Enumeration Date:
08/08/2019