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General NPI Number Information
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NPI Number | 1811023047
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Entity Type | Individual
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Provider Name | CASEY CONWAY RCS
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Gender | Female
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4161 TAMIAMI TRL # 701
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-9204
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Country | US
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Telephone | 941-916-5371
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Fax |
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Provider Business Mailing Address
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Address Line | 26410 RAMPART BLVD APT 723
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City | PUNTA GORDA
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State | FL
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Zip | 33983-6607
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Country | US
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Telephone | 941-916-5371
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 00053524
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License Number State | FL
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