# PR MEDICAL SERVICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205388121
- **Authorized official:** LOURDES M RIVERA VELEZ (PRESIDENT)
- **Authorized official phone:** (787) 966-7575

## Contact information

- **Practice address:** 16 AVE AGUAS BUENAS SUITE 34 ALTOS, URB SANTA ROSA, BAYAMON, PR 00959
- **Practice address phone:** (787) 966-7575
- **Practice address fax:** (787) 966-7575
- **Mailing address:** 16 AVE AGUAS BUENAS SUITE 34 ALTOS, URB SANTA ROSA, BAYAMON, PR 00959
- **Mailing address phone:** (787) 966-7575
- **Mailing address fax:** (787) 966-7575

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085D0003X | Diagnostic Neuroimaging (Radiology) Physician | — | NULL | — |
| 2085D0003X | Diagnostic Neuroimaging (Radiology) Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |

## Other

- **Enumeration date:** 10/26/2016
- **Last updated:** 06/20/2018