MEDICARE: CONAWAY RENTA & ASOCIADOS CARDIOVASCULAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1346246568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONAWAY RENTA & ASOCIADOS CARDIOVASCULAR

Provider Business Mailing Address
First Line	:	PO BOX 362309
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-2309
Country	:	US
Telephone Number	:	787-767-4450
Fax Number	:	787-767-5003

Provider Business Practice Location Address
First Line	:	AVE. FD.ROOSEVELT 400 CLINICA LAS AMERICAS
Second Line	:	SUITE 203
City	:	HATO REY
State	:	PR
Zip	:	00918
Country	:	US
Telephone Number	:	787-767-4450
Fax Number	:	787-767-5003

Authorized Official
Title or Position	:	PRESIDENTE
Name	:	DR. RALPH CONAWAY
Credential	:	M.D.
Telephone Number	:	787-763-9468

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	01/30/2008

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