Provider Demographics
NPI:1912062548
Name:MUJICA, HILDA VIOLETA (MD)
Entity type:Individual
Prefix:DR
First Name:HILDA
Middle Name:VIOLETA
Last Name:MUJICA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:LIRIO ST. 211 CIUDAD JARDIN CAROLINA PR 00987
Mailing Address - City:CANOVANAS
Mailing Address - State:PR
Mailing Address - Zip Code:00729-0525
Mailing Address - Country:US
Mailing Address - Phone:787-257-1164
Mailing Address - Fax:787-256-1775
Practice Address - Street 1:83 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-3217
Practice Address - Country:US
Practice Address - Phone:787-876-5266
Practice Address - Fax:787-256-1775
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9436208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE63008Medicare UPIN
PR0081836Medicare ID - Type Unspecified