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General NPI Number Information
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NPI Number | 1679102610
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Entity Type | Individual
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Provider Name | MOHAMMAD MOSTAFA DLEWATI
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Gender | Male
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 703 N FLAMINGO RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1006
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Country | US
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Telephone | 954-844-1401
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Fax |
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Provider Business Mailing Address
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Address Line | 3618 SW 163RD AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-4510
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Country | US
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Telephone | 810-410-8242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS21415
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License Number State | FL
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