Provider First Line Business Practice Location Address:
FERNANDEZ MEDICAL BUILDING FERNANDEZ ST. #6
Provider Second Line Business Practice Location Address:
4TH FLOOR
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-764-9662
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2006