Organization
SOUTH WESTERN RADIOLOGY SERVICES PSC
Active
Other names
ADVANCED MRI & CT INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL MEDINA M.D. (PRESIDENT)
(787) 807-0900
Entity
Organization
Contact information
Practice address
D10 CALLE 2, URB. VILLA REAL, VEGA BAJA, PR 00693-4611
(787) 807-0900
(787) 855-2729
Mailing address
PO BOX 1498, VEGA BAJA, PR 00694-1498
(787) 807-0900
(787) 855-2729
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
05-265
PR
261QR0200X
Radiology Clinic/Center
Primary
05-265
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008-4912
MEDICARE PTAN
PR
Enumeration date
03/08/2006
Last updated
10/23/2025
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