Provider First Line Business Practice Location Address:
18 AVE. SEVERIANO CUEVAS
Provider Second Line Business Practice Location Address:
HOSP. BUEN SAMARITANO SUITE 100
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-882-5100
Provider Business Practice Location Address Fax Number:
787-882-5140
Provider Enumeration Date:
01/30/2006