Provider First Line Business Practice Location Address:
CARR #2 KM 11.6
Provider Second Line Business Practice Location Address:
BAYAMON MEDICAL PLAZA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00960
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-786-8221
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/03/2020