Provider First Line Business Practice Location Address:
SUITE 205 CARR.21 #1785 LAS LOMAS
Provider Second Line Business Practice Location Address:
HOSPITAL METROPOLITANO
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-781-8506
Provider Business Practice Location Address Fax Number:
787-749-0392
Provider Enumeration Date:
06/16/2005