Provider Demographics
NPI:1346246568
Name:CONAWAY RENTA & ASOCIADOS CARDIOVASCULAR
Entity Type:Organization
Organization Name:CONAWAY RENTA & ASOCIADOS CARDIOVASCULAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CONAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-763-9468
Mailing Address - Street 1:PO BOX 362309
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2309
Mailing Address - Country:US
Mailing Address - Phone:787-767-4450
Mailing Address - Fax:787-767-5003
Practice Address - Street 1:AVE. FD.ROOSEVELT 400 CLINICA LAS AMERICAS
Practice Address - Street 2:SUITE 203
Practice Address - City:HATO REY
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-767-4450
Practice Address - Fax:787-767-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0080073BMedicare PIN
PR0080073AMedicare PIN