Provider First Line Business Practice Location Address:
CARR. #2 KM 39.5
Provider Second Line Business Practice Location Address:
HOSPITAL WILMA N. VAZQUEZ SUIT 101
Provider Business Practice Location Address City Name:
VEGA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00693-3512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-858-3550
Provider Business Practice Location Address Fax Number:
787-855-3339
Provider Enumeration Date:
12/12/2006