Provider First Line Business Practice Location Address:
#1 SANTA RITA MARGINAL
Provider Second Line Business Practice Location Address:
CARIBE MEDICAL PLAZA SUITE 207
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-361-4420
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2014