Provider First Line Business Practice Location Address:
DR. CLEMENTE FERNANDEZ STREET NUMBER 8
Provider Second Line Business Practice Location Address:
1ST FLOOR
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00984
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-276-6615
Provider Business Practice Location Address Fax Number:
787-257-3370
Provider Enumeration Date:
09/13/2005