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Organization

MANUEL MEDINA

Active
Parent organization
SOUTH WESTERN RADIOLOGY SERVICES PSC
Other names
Advanced MRI & CT Institute
Organization subpart
Yes

Provider details

NPI number
Legal business name
SOUTH WESTERN RADIOLOGY SERVICES PSC
Authorized official
MRS. MARIELY GONZALEZ (OFFICE ADMINISTRATOR)
(787) 607-1591
Entity
Organization

Contact information

Practice address
ROAD PR-2 MARGINAL D-10, URB. VILLA REAL, VEGA BAJA, PR 00694
(787) 807-0900
(787) 855-2729
Mailing address
PO BOX 1498, VEGA BAJA, PR 00694-1498
(787) 807-0900

Taxonomy

Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
261QR0200X
Radiology Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1780652594
SC
Enumeration date
05/15/2024
Last updated
05/15/2024
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