Provider First Line Business Practice Location Address:
UNIVERSITY PEDIATRICS HOSPITAL OFFICE 1 A 29
Provider Second Line Business Practice Location Address:
CENTRO MEDICO PR BO MONACILLOS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00935-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-756-4020
Provider Business Practice Location Address Fax Number:
787-777-3227
Provider Enumeration Date:
06/27/2006