Provider First Line Business Practice Location Address:
HOSPITAL SAN LUCAS II LOBBY
Provider Second Line Business Practice Location Address:
AVE TITO CASTRO CARR 14 BO MACHUELO
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-844-2080
Provider Business Practice Location Address Fax Number:
787-841-4832
Provider Enumeration Date:
06/16/2005