Provider First Line Business Practice Location Address:
1156-1178 CALLE 62 SE
Provider Second Line Business Practice Location Address:
UNIVERSIDAD DE PUERTO RICO MEDICAL SCIENCE CAMPUS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-207-2602
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2017