Healthcare Provider Details

I. General information

NPI: 1548182090
Provider Name (Legal Business Name): PEDRO MOSTAFA ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12264 TAMIAMI TRL E STE 201
NAPLES FL
34113-7942
US

IV. Provider business mailing address

12264 TAMIAMI TRL E STE 201
NAPLES FL
34113-7942
US

V. Phone/Fax

Practice location:
  • Phone: 239-304-9071
  • Fax:
Mailing address:
  • Phone: 305-336-0309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number11049559
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: