Provider First Line Business Practice Location Address:
NAGUABO MEDICAL MALL
Provider Second Line Business Practice Location Address:
CARR 31 KM 4.0
Provider Business Practice Location Address City Name:
NAGUABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00718-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-874-3152
Provider Business Practice Location Address Fax Number:
787-874-3125
Provider Enumeration Date:
12/08/2005