Provider Demographics
NPI:1679542286
Name:MUJICA, LUISA JOSEFINA (MD)
Entity type:Individual
Prefix:DR
First Name:LUISA
Middle Name:JOSEFINA
Last Name:MUJICA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10156
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-0156
Mailing Address - Country:US
Mailing Address - Phone:787-298-5060
Mailing Address - Fax:
Practice Address - Street 1:CARR 877 K.M 1.6
Practice Address - Street 2:CAMINO LAS LOMAS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-760-0222
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15243170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRI02907Medicare UPIN