# CANOVANAS MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Canovanas Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285855411
- **Authorized official:** MS. HILDA V MUJICA M.D. (PRESIDENTA)
- **Authorized official phone:** (787) 256-7642

## Contact information

- **Practice address:** 61 CALLE PALMER, CANOVANAS, PR 00729-3116
- **Practice address phone:** (787) 256-7642
- **Practice address fax:** (787) 876-5260
- **Mailing address:** PO BOX 525, CANOVANAS, PR 00729-0525
- **Mailing address phone:** (787) 256-7642
- **Mailing address fax:** (787) 876-5260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QV0200X | VA Clinic/Center | — | PR | Yes |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 08/22/2020