Provider First Line Business Practice Location Address:
MEDICAL OPHTHALMIC PLAZA
Provider Second Line Business Practice Location Address:
1875 CARR 2 SUITE 303
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-7217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-780-0404
Provider Business Practice Location Address Fax Number:
787-780-0411
Provider Enumeration Date:
01/24/2006