Provider First Line Business Practice Location Address:
MEDICAL OPHTALMIC PLAZA
Provider Second Line Business Practice Location Address:
OFIC 107
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-740-5524
Provider Business Practice Location Address Fax Number:
484-952-2333
Provider Enumeration Date:
12/13/2005