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General NPI Number Information
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NPI Number | 1952567513
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Entity Type | Individual
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Provider Name | MUHAMMAD R MUSTAFA MD
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Gender | Male
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 1625 SE 3RD AVE STE 721
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2521
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Country | US
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Telephone | 954-831-7263
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Fax | 954-712-3970
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Provider Business Mailing Address
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Address Line | 1700 NW 49TH ST STE 125
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309-3750
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Country | US
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Telephone | 954-831-2763
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Fax | 954-712-3970
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 268720
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License Number State | FL
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