Healthcare Provider Details

I. General information

NPI: 1548962780
Provider Name (Legal Business Name): EMILIJA CONEVA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 CALLE CERRA APT 4A
SAN JUAN PR
00907-3619
US

IV. Provider business mailing address

PO BOX 13431
SAN JUAN PR
00908-3431
US

V. Phone/Fax

Practice location:
  • Phone: 562-336-7983
  • Fax:
Mailing address:
  • Phone: 562-336-7983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number086827
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN95182842
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11026054
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: