Provider First Line Business Practice Location Address:
PARRA MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
2225 PONCE BYP STE 403
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717-1322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-259-3391
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/10/2019