=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013885029
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NATIONAL CARDIAC AND VASCULAR CONSULTANT LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2025
-----------------------------------------------------
Last Update Date | 12/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 310 NESBIT ST
-----------------------------------------------------
City | PUNTA GORDA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33950-3828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-559-8995
-----------------------------------------------------
Fax | 941-559-8996
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 310 NESBIT ST
-----------------------------------------------------
City | PUNTA GORDA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33950-3828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 941-559-8995
-----------------------------------------------------
Fax | 941-559-8996
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JIHAD ALI MUSTAPHA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 941-559-8995
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------