Provider First Line Business Practice Location Address:
CARR NUM 2
Provider Second Line Business Practice Location Address:
SECOND FLOOR HERMANOS MELENDEZ HOSP
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-787-7043
Provider Business Practice Location Address Fax Number:
787-780-8091
Provider Enumeration Date:
03/21/2006