Provider First Line Business Practice Location Address:
ANTIGUO HOSPITAL SAN LUCAS
Provider Second Line Business Practice Location Address:
CALLE GUADALUPE FINAL
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-842-3352
Provider Business Practice Location Address Fax Number:
787-842-3352
Provider Enumeration Date:
07/18/2006