Provider First Line Business Practice Location Address:
CENTRO MEDICO DE PR.
Provider Second Line Business Practice Location Address:
BO MONACILLOS
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-777-3760
Provider Business Practice Location Address Fax Number:
787-777-3781
Provider Enumeration Date:
12/29/2016